cautery/ plug getting loose due to allergens

[jenny2008]

has anyone on here had cautery done and if so does it keep 100% of tears in?
My one plug wants to come out with the allergy season.. it seems that the tear duct expands with allergies and the plug pops up a little ... anyone else have this issue???

[hirentherock]

i have got cautery done before 2 years.
So far it seems its not opened up.Yes no doubt cautery is safe bet to block duct instead of plugs.

I have read in expert columns that there r rare chance that cautery can also open up...but its happens seldom.

[spmcc]

RE: cautery

I've had my lower puncta cauterized twice... both times they opened back up. And most people who I know who had cautery also had them open up after some time. My optometrist had cautery and he just told me that he has to have it done yearly to close them up.

I was just told by Dr. Friedman in Palo Alto (one of the doctors doing IPL for dry eyes a la Toyos technique) that there are lid specialists who can cauterize and suture puncta closed so that there is more certainty that it/they will not reopen.

My ophthalmologist also said that if a plug tends to pop out that a larger size is needed.

[indrep]

Different studies show cautery working 50-80% at 12 months.

There are many reasons for plugs to fall out:
Too large a plug inserted first time
Punctal ring does not retract after dilation to insert plugs
Patient accidentally pulls plug up or out

These are the most common reasons.

[jenny2008]

it hasn't fallen out--yet... it seems that every year during allergy season i loose a plug or two.. it seems that when my eyes are flared up with allergies the puntual opening tends to swell open and the plug moves up and down a bit....it is common to loose a plug about once a year huh??

thanks for the responses on cautery... if it has to be redone yearly it looks like plugs may be better to deal with