LACRIMAL PLUGS AS A THERAPY FOR CONTACT-LENS INTOLERANCE

We investigated whether canalicular occlusion with a lacrimal plug cou ld increase objective and/or subjective comfort in contact lens (CL) w earers (n = 9) with both a history of lens intolerance and relative te ar fluid deficiency, A modified Schirmer test (MST) was performed with the lids closed and under topical anaesthesia. Patients with values o f less than or equal to 10 mm/5 min were included. The plugs were inse rted into the inferior canaliculus of the eye with the lower MST resul t; the contralateral eye served as a control, Conjunctival hyperaemia, Rose-Bengal and fluorescein scores, as well as subjective irritation, decreased significantly in plugged eyes at the 1 month follow-up visi t but had returned to the pre-operative level at the 3 month visit, Te ar fluid plasmin activity was elevated prior to plug insertion, Plasmi n activity of the plugged eye was significantly lower at the 1 month v isit but neither tear fluid flow (in the collection capillary) nor pla smin release showed any changes. The mean MST value improved insignifi cantly, whereas conjunctival chemosis and limbal hyperaemia showed no improvement at the 1 or 3 month follow-up visits after inferior puncta l occlusion, Occlusion of the Lower canaliculus,vith a lacrimal plug s eems to induce a relatively short-lasting subjective and objective ben efit for CL wearers, Plug escape or adaptive changes in lacrimal fluid secretion/elimination rate probably took place during the followup, T he association of increased plasmin activity with tear deficiency migh t lead to enhanced tissue proteolysis, and thus contribute to CL-relat ed ocular surface changes.