Ocular surface changes in XXXX sicca with @entity1346 punctum plug occlusion.

@entity1 @entity9849 @entity1346 @entity936 @entity941 @entity432 @entity942
PURPOSE: To evaluate histopathologic and clinical response to @entity1346 plug insertion in @entity936 @entity1 . METHODS: Punctal plugs were placed in 32 eyes of 18 @entity936 @entity1 with @entity942 who were on maximum medical therapy and who had Schirmer testing with topical anesthetic measuring less than 5 mm. Pre-treatment and post-treatment (6 weeks and 1 year) evaluations included temporal and inferior quadrant impression cytology examinations, Schirmer-1, BUT, corneal @entity941 and rose-bengal staining patterns and questionnaire scores. The cytology samples were graded according to the method described by Nelson. RESULTS: There was an improvement in subjective symptoms of @entity1 6 weeks after @entity432 . Corneal @entity941 and rose-bengal staining scores decreased from a mean of 5.33 +/- 1.74 to 1.37 +/- 1.48 and from 5.90 +/- 1.2 to 2.45 +/- 1.89 (p < 0.05) respectively. BUT values increased from 2.98 +/- 1.1 to 11.3 +/- 3.1 seconds (p < 0.05) at 6 weeks post-treatment. Increase in goblet cell density was observed after @entity432 at 6 weeks (p < 0.05) and at 1 year (p < 0.05) compared to the pre-treatment values. After occlusion, 3% of temporal specimens had Grade 0 squamous metaplasia, 63% had Grade 1, 34% had Grade 2; while 25% of inferior specimens had Grade 0, 56% had Grade 1, 19% had Grade 2 squamous metaplasia. CONCLUSIONS: Punctum plug occlusion in @entity9849 sicca provides improvement of tear film stability, ocular surface staining scores, conjunctival squamous metaplasia grades and goblet cell density. Increased ocular surface exposure to essential tear components with @entity432 may be important for the genesis of these changes.
