Cautery vs. Stitching

[infoseeker]

I recently had lower plugs inserted and had to have them pushed farther in a week later. I think they are Oasis brand and I can see the tops of them. I was asking my eye doctor about cautery of the puncta and he said he does not do cautery but he does stitch the opening closed. I have not seen anyone on this forum mention this option.

I have severe dry eye that is so bad it is causing the healed incisions of my RK (from 20 years ago!) to come open. I think the plugs are helping a little as I don't seem to be using eye drops as much during the day. I still use Refresh PM at night and sleep with Tranquileyes goggles.

Has anyone every heard of stitching the puncta closed?

Thanks!

[djb]

Dr. Don Liu from Columbia, MO did research and wrote an article back in 2002 I believe on 'stitching'/suturing punctum closed after using a rotary burr tool to make the flesh 'raw' and then suturing it closed. I believe the procedure is called simple incision with suturing. He found it highly successful in permanently closing off the punctal openings. I'm considering traveling to Dr. Liu in the future to have one of my punctum closed off with this method. Cautery was only successful in one of my punctum. I have been cauterized multiple times by different doctors. Dr. Liu said the procedure is simple and I should be able to find someone in the Northeast who could do it but I haven't found one yet. Can I get the name of your doctor in Texas who 'stitches' for a possible future reference?

[djb]

Talked to a doctor yesterday about cautery. He uses dissolvable sutures after cautery to achieve better results. I'm going to give it a try next month. He also said there was more than one type of thermal cautery. He uses the Bovie thermal cautery unit. I don't know what the differences are???

[spmcc]

Re: cautery vs stitching

I was told by an ophthalmologist that an oculoplastic (ophthalmologist) would be the person who performs procedures to close puncta with stitches and other tricks besides just plain ol' cautery.

[djb]

Yeap! That's who I was talking too....he's the third one I will visit! The first one lacerated one of my punctum and lied to me. The second one was partially successful. The rest who attempted occlusion weren't "oculoplastics".

[indrep]

before going with permanent closure ask your doc about 90 day plugs.