Effect of plugs?

[Carina]

Hi everyone!
I got temporary collagen plugs in my lower punctums yesterday. When I came home yesterday, my right eye hurt and when I look ed in the mirror I saw that the plug came out a little bit and was scratching my eye. I pushed it back in and then eyerything was okay. Now I am wondering if there is the possibility that I lost the plugs. I do not feel a great difference. I somehow was expecting an immediate effect, something like feeling the eyes getting wet. How long does it take to feel an effect? Can I evaluate if the plugs are good for me after 5 days (they will resolve after 5 days).
anyway, I do not even feel bad. My eyes do not feel especially wet but they do not even hurt much.

[indrep]

The collagen plugs only last 3-5 days. This is enough for the lubricating effect of having more tears on the eye to give you some relief. For the more beneficial effect of plugs you will need a few weeks. This gives time for the increased tear film to begin decreasing the osmalarity of the tear and allowing your cornea to begin recieving more nutrients.

[kitty]

Carina, I had all four punctum plugged with the collagen plugs. I noticed increased comfort the next day, and the day following. I was then back to square one after that. I have now had permanent plugs in my lowers for nearly two weeks, and have not seen any significant change in my dryness. You might consider repeating the trial with all four punctum plugged, to see if you find any significant change in your comfort level.

[sparrow]

Kitty,

I'm having the same experience and wondered how that could be possible. I felt great immediately after getting plugs for the first day, but it only lasted one day and after that, back to square one (or worse actually if you count the scratchiness from the plugs). I go back to the dr tomorrow for my one week checkup and am going to have them removed.

[Annie]

Carina, I had all four punctum plugged with the collagen plugs. I noticed increased comfort the next day, and the day following. I was then back to square one after that. I have now had permanent plugs in my lowers for nearly two weeks, and have not seen any significant change in my dryness. You might consider repeating the trial with all four punctum plugged, to see if you find any significant change in your comfort level.

Hi there,
I read your comments and thought you might be interested in my experience. I used to have collagen plugs in quite often. It is so expensive and they do not last. I now have permanent plugs in lower and a silicone plug in upper left eye only. I have been comfortable since the eye dr. put that in. I have had recurrent corneal erosions and had two stromal punctures done. That erosion is extremely painful. I have struggled with this dry eye thing for 7 years. Right now I am comfortable just using the refresh plus drops. I work at a computer all day so I have quite a chance of getting pain every day, but now I am better. I also have a tear film deficiency and ocular rosacea.

Annie

[JoeB]

Collagen or Permanent?

Hi there,
I read your comments and thought you might be interested in my experience. I used to have collagen plugs in quite often. It is so expensive and they do not last. I now have permanent plugs in lower and a silicone plug in upper left eye only. I have been comfortable since the eye dr. put that in. I have had recurrent corneal erosions and had two stromal punctures done. That erosion is extremely painful. I have struggled with this dry eye thing for 7 years. Right now I am comfortable just using the refresh plus drops. I work at a computer all day so I have quite a chance of getting pain every day, but now I am better. I also have a tear film deficiency and ocular rosacea.

Annie

I often hear people not getting any benefit from using collagen first. Is it more sensible to just get all four plugs inserted using silicone punctal plugs? That way a person can get a real idea if they work or not.

What does anyone think of that idea? Indrep, any input?

By the way, Annie, what do you mean that you have permanent plugs in lower and silicone in upper left, only. Aren't they all permanent (but still able to be pulled out if necessary) and made of silicone or is there some difference?

JoeB

[kitty]

I saw some benefit from collagen plugs in all four for a couple of days. When I went to get the "permanent" silicone plugs, my doc said he would only plug the lowers. For some reason he is really hesitant to plug all four. Even when I went back for follow up he still would not do the other two. He wanted to see if Restasis would help before putting in the other two. I think in my case part of his rationale was that he had so much difficulty getting the collagen plugs into my upper puncta. He also would rather not have to remove them. I have read that not everyone sees benefit from the short term (5 day) collagens. You could try a 6 month dissolvable plug before committing to the permanent silicone plugs. Often times I wished I had all four plugged to start with. This is a call that only you and your doctor can make.

[JoeB]

Good Information

Thanks Kitty for the information. All of it helps.

Joe

I saw some benefit from collagen plugs in all four for a couple of days. When I went to get the "permanent" silicone plugs, my doc said he would only plug the lowers. For some reason he is really hesitant to plug all four. Even when I went back for follow up he still would not do the other two. He wanted to see if Restasis would help before putting in the other two. I think in my case part of his rationale was that he had so much difficulty getting the collagen plugs into my upper puncta. He also would rather not have to remove them. I have read that not everyone sees benefit from the short term (5 day) collagens. You could try a 6 month dissolvable plug before committing to the permanent silicone plugs. Often times I wished I had all four plugged to start with. This is a call that only you and your doctor can make.

[indrep]

Joe
I think conservative is always best. If you plug all four and then need to remove two yo have paid for something you didn't need. The collagens only last 3-5 days, most peolpe see some benefit immediately some don't. Also remember that plugging one puncta only stops half the flow from leaving your eye. I think the two lowers first then wait 2-4 weeks and see how it goes.

[JoeB]

Query

Thanks for the reply, Indrep.

Everyone knows the importance of keeping the eyelids clean and using warm compresses on the eye, but how does one do those two things without disturbing the plugs? Any special techniques.

Joe

[SusieD]

With the silicone plugs with the cap on them - I managed to do lid cleaning and warm compresses without disturbing them - just did the same as before I had the plugs. I think as long as they have been fitted correctly - right sizing etc, then its quite hard to dislodge them, unless you're really scrubbing/rubbing at your eyes - which you shouldnt really be doing anyway.

With other plugs such as smartplugs - Im not sure about warm compresses.

[indrep]

I am going with Susuie on this one. Just be careful when you are close to the plug.

[JoeB]

Thanks SusieD & Indrep.

Joe