Comparison of Retention Rates and Complication Profiles of Two Silicone Lacrimal Punctal Plugs in Dry Eye Disease Management

Abstract

Background: Dry eye disease (DED) is a common ophthalmic condition that significantly impacts the quality of life. Lacrimal punctal plugs are a widely used treatment option to enhance tear retention. However, differences in retention rates and complications among various types of silicone punctal plugs remain a subject of clinical interest.

Aim: The purpose of this study was to evaluate two distinct silicone lacrimal punctal plug types for the treatment of dry eye illness in terms of retention rates, complication profiles, and patient-reported symptom alleviation.

Methods: A prospective, randomized controlled trial was conducted on 80 participants diagnosed with DED. Patients were randomly assigned to receive either Type 1 (Group A, n=40) or Type 2 (Group B, n=40) silicone punctal plugs. Retention rates, complications, and symptom relief (measured using a visual analog scale, VAS) were assessed at 1 week, 1 month, and 3 months post-procedure. Statistical analysis was performed using SPSS version 23.0, with a significance level set at p<0.05.

Results: At 3 months, retention rates were higher in Group B (77.5%) than in Group A (62.5%), though the difference was not statistically significant (p=0.14). Plug extrusion was the most common complication, occurring more frequently in Group A (37.5%) than in Group B (22.5%). Patient-reported symptom relief was significantly better in Group B at 1 month (p=0.03) and 3 months (p=0.02). Kaplan-Meier survival analysis suggested longer plug retention in Group B, but this was not statistically significant (p=0.09).

Conclusion: Both types of silicone lacrimal punctal plugs were effective in improving dry eye symptoms, with Group B showing a trend toward better retention, fewer complications, and greater symptom relief. Although statistical significance was not reached in some parameters, the observed differences suggest that Type 2 plugs may offer better clinical outcomes.

Recommendations: Further large-scale studies with longer follow-up periods are recommended to confirm the superiority of Type 2 plugs in terms of retention and patient satisfaction. Clinicians should consider plug selection based on retention rates and patient comfort for optimal DED management.

Keywords: Dry eye disease, lacrimal punctal plugs, silicone plugs, retention rates, symptom relief