Scintigraphic evaluation of the degree of lacrimal duct occlusion after implantation of an intracanalicular plug

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Abstract
Intracanalicular plugs are easy to set in, ocular tolerance is excellent and only few complications of canaliculitis and dacryocystitis have been reported. However, their real interest for dry eye treatment is controversial. Spontaneous migration and expulsion is suspected but study of the occlusive effect by seringuing or probing is contraindicated and the radio-opacity is not sufficient. Thus we have used dacryoscintigraphy (DSG) to evaluate the degree of occlusion of the lacrimal flow. METHODS 10 patients with dry eye and good patency of the excretory lacrimal system were treated with superior and inferior intracanalicular plugs in one eye while the other eye served as a control. DSG was performed 15 days thereafter and then between I and 3 months. RESULTS After 15 days the occlusive effect at DSG was total in 5 patients, partial in 3 patients and null in two. One month later none of the patients showed any occlusion. DISCUSSION Subjective improvement of dry eye due to a placebo effect is known. Dacryoscintigraphy appears to be a good and safe procedure to evaluate objective lacrimal flow obstruction. Only 10 patients were enrolled in our study but it seems that intracanalicular plugs have only a short-term and/or partial occlusive effect and that they are not efficient for prolonged lacrimal occlusion.

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