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Visual Function Changes After Punctal Occlusion With the Treatment of Short BUT Type of Dry Eye

Kaido, Minako MD; Ishida, Reiko MD; Dogru, Murat MD; Tsubota, Kazuo MD

doi: 10.1097/ICO.0b013e31823f8cfc
Clinical Science

Purpose To evaluate visual function changes after punctal plug (PP) occlusion in patients with short breakup time of tear film (BUT) type of dry eyes.

Methods A prospective comparative study was performed in 43 eyes of 43 dry eye patients with short BUTbreakup time of tear film receiving PP occlusion. Patients were divided into 2 groups as those receiving only upper or only lower occlusion. Functional visual acuity measurements, tear function evaluations, and questionnaire on satisfaction with treatment in relation to presence of epiphora were performed before and 1 month after PP insertion.

Results Twenty eyes of 43 eyes (46.5%) with only lower occlusion and 17 eyes of 43 eyes (39.5%) with only upper occlusion showed satisfactory outcomes with treatment. One of 43 eyes (2.3 %) had epiphora. Vital staining scores and BUT values significantly improved in both groups after occlusion. The mean logarithm of the minimum angle of resolution functional visual acuity value significantly improved only in eyes receiving upper PP occlusion.

Conclusion Upper PP occlusion seems to be associated not only with improvement of tear stability, vital staining scores, and treatment-related satisfaction but also with better quality of visual function.

*Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan

Johnson & Johnson Department of Ocular Surface and Visual Optics, Keio University School of Medicine, Tokyo, Japan.

Reprints: Minako Kaido, Department of Ophthalmology, Keio University School of Medicine, Shinanomachi 25, Shinjuku-ku, Tokyo 160-8582, Japan (e-mail:

Presented at the 63rd Japan Clinical Ophthalmology Congress, October 2009, Sapporo, Japan.

The authors have no financial or conflicts of interest to disclose.

Received March 18, 2011

Accepted July 18, 2011

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