I'm new and need advice for a decision!

[cpuguy]

(sorry, I posted this earlier in the wrong section, apparently)

Well, quick story on me. I had LASIK done over 10 years ago and I've had plugs in my eyes ever since as dry eyes resulted after LASIK. I've functioned with plugs by using Refresh Tears. I've taken them every where I go. For the most part, I've just gotten used to this lifestyle. Sometimes, I may have to use tears 5 or 6 times or more a day. Other times, I may not use them but 1 or 2 times. I always use drops right before getting into bed and I never wake up because my eyes are dry.

That's pretty much my routine. Last year, I lost a plug in the left eye and after a couple of tries my doctor found the correct size to replace. That's been working fine and I only feel it when I look to the right. But it's not really irritating my eyes and poses no real inconvenience to me. Still I have to use drops.

Last week, I lost the plug in my right eye. I found out about cautery after my left plug fell out. I've considered it now with the right plug out and I'm scheduled to go in for the procedure this Saturday. I found this forum and I've done some more reading and I'm having second thoughts. Mainly, I guess I'm concerned that the cautery won't work and the duct will reopen. I don't think I'm really concerned with infection or complications afterwards. I'm definitely not concerned about the permanence. My doctor is good, I believe, and he told me he's pretty thorough so I think he'll do a good job.

My main question is whether it's really worth it. If there's a chance that the duct will open again no matter how good my doctor is, I don't really think it's worth it. Plugs don't really bother me, but if cautery works and maybe works better than plugs to reduce how much I have to rely on artificial tears, it would be worth it.

Any advice or wisdom on the subject would be greatly appreciated!

Thanks

[Mawsky]

Hi, I can not have plugs in my lower punctum's because I actually had punctual stenosis (unknown cause) about three or so yrs. Ago, I had two surgeries to open them, pretty ironic now, as I'm considering having them permanently closed again. As far as them reopening I don't know how that would ever be possible the scar tissue that forms would be permanent I would think just like a cut that heals it wouldn't come open again. Please post about the proceedure
after you do it I'm very curious about how it is done. Be glad that you could have a trial with the plugs, my plastic surgeon wants to sew mine shut first to trial how I do before he would do anything permanent.

[Aaron77]

I had a doctor try to cauterize my right punctum but it did'nt work, now I've got a plug in it but it is terribly uncomfortable - I now worry that the lack of comfort may have something to do with scar tissue that was created when the doc tried the cauterization...

[Rebecca Petris]

I know a lot of people who are successfully cauterized. Tough decision though. For myself, I don't like anything invasive at all unless it's really crucial, but then I'm not plugged either. For people who have benefitted from plugs for a very long time cautery makes sense, but as you'll see from our punctal occlusion archives there are plenty of exceptions where it may not work out so great.

[cpuguy]

I know a lot of people who are successfully cauterized. Tough decision though. For myself, I don't like anything invasive at all unless it's really crucial, but then I'm not plugged either. For people who have benefitted from plugs for a very long time cautery makes sense, but as you'll see from our punctal occlusion archives there are plenty of exceptions where it may not work out so great.

This is what gives me pause, Rebecca. If I've survived on this for so many years, it almost seems silly to change it. There is no guarantee that cautery will work any better than plugs so I'd still have to rely on them. And the risk is always there that it could make things worse. I may go through more of the archives. Thanks for the input.