plugs lasted 2 days @$#^*(

[hypogal]

Newbie here (wave)
I just had plugs put in that only lasted 2 days!
I went back to the Dr and was told I would have to pay again!
Anyone else have this problem?
They were wonderful for the 2 days I had them and I knew they were out because the dryness was back. I paid $500.00 per plu so I'm very ticked.

[kitty]

So sorry to hear about the loss of the plugs. What kind were they? If they are the type that protrude from the punctum, it might be that your doctor did not use the right size.

[hypogal]

Unfortunately I don't know what type they were.
I'm trying to get in touch with the administrator to erase the fee for the plugs. If I ever hear from her I'll ask
What really ticks me off is I got them put in at the Jules Stein Eye Inst. I expected better.

[kitty]

Hypogal, I just want to confirm. Were these temporary or permanent plugs? The temporary ones might only give about two days of relief (mine did).

[hypogal]

Well, right before they were inserted I asked about how long they should last and I was told "at least six months, probably longer".

[kitty]

Thanks. You had semi-permanent plugs. When I got my temporary plugs (the one week ones), one fell out as soon as I got to the car. The 7 day and the 6 month ones are designed similarly. They do come out if not put in deep enough. I certainly would ask for complimentary replacements. They should not be gone in two days if they were inserted properly.

[indrep]

There is a "six" month plug advertised, unfortunately many practices have experienced what happened with you. Sometimes they don't last a week. There are 90 day plugs that do hold for 80-100 days, many companies have them and many practices use them. With the benefit you experienced you might want to go ahead with the silicone or intracanalicular plugs that are available. Maybe from a different doc.

[SusieD]

You paid $500 per (temporary) plug? Thats just wrong!

Now they want you to pay again to have them replaced.

Maybe the NHS (uk) for all its faults, isnt so bad after all - we can get plugs inserted free, so at least if they're rubbish or fall out, you're not out of pocket.

[indrep]

The Medicare reimbursement for punctal occlussion is $170 for the first puncta and $85 for each puncta plugged at the same time. BC/BS pays more, not much, but they also reimburse for the office visit and flushing of the puncta to make sure there is no other obstruction. These fees can approach $1000. If I paid, or my insurance paid (which means you ultimately pay), and they came out I would expect the practice to replace them for free, once.

[neil0502]

Way back when--in my wild and wooly, pre-cauterized and misspent youth--my (very limited) experience was: if they used the "dilator" to enlarge my puncta, then inserted a slightly oversized plug ... it stayed in.

If they didn't ... it didn't.

YMMV.

[Carina]

I also have semi-permanent plugs. I got them 2 weeks befor but I do not notice much of a difference. How do you know that your plugs had fallen out? I don't see how I can know that. How long does is usually take to notice a difference?

[sazy123]

Maybe the NHS (uk) for all its faults, isnt so bad after all - we can get plugs inserted free, so at least if they're rubbish or fall out, you're not out of pocket'

mmm but all the rest of its faults dont quite make up for it! We dont have to pay but if it but if it falls out we have to wait months for another appointment!

I too had plugs i think they were slicone, they sat over the top where you can see them. and they fell out the same day! they might not have been measured properlly, i did keep rubbing my eyes coz there was irritaion might have been becuas eof the bad fit or just the plug i dont know.

I dont though why plugs are that expensive, seems stupid when there loads of brands now, think they would lower the prices.

[DrG]

The Medicare reimbursement for punctal occlussion is $170 for the first puncta and $85 for each puncta plugged at the same time. BC/BS pays more, not much, but they also reimburse for the office visit and flushing of the puncta to make sure there is no other obstruction. These fees can approach $1000. If I paid, or my insurance paid (which means you ultimately pay), and they came out I would expect the practice to replace them for free, once.

Hold on there, "rep."

If I charge the insurance reimburseable (i.e. Medicare) amount(as I always do), and had to replace a set of plugs for free, most of my profits from that procedure are gone(not smart). Unless purchased in bulk, punctal plugs are quite expensive, usually sold in sets of two, pre-mounted on a stylus type of inserter. If I need one plug, I have to open a complete set, thereby compromising the sterility of the remaining plug. What I will do, subject to my discretion, is to charge half for a new plug, especially if it appeared as if the initial plug was undersized. I found that I wasted too many plugs packaged in bulk.

Thanks for the info on BC/BS, though.

[DrG]

I too had plugs i think they were slicone, they sat over the top where you can see them. and they fell out the same day! they might not have been measured properlly, i did keep rubbing my eyes coz there was irritaion might have been becuas eof the bad fit or just the plug i dont know.

It seems like one person's bad experience tends to set the general tone....

I can tell you from first hand experience that trying to accurately measure the size of the soft punctum with a stainless steel gauge is far from being a science. After years of experience I have learned to judge the size of the punctum visually. That, plus the availability of softer, more deformable plugs that can expand after insertion, have increased the success rate.

Still, plugs can fall out, and rubbing the eyes can contribute to the loss. The plugs may not have been fully seated, and were rubbing the conjunctiva. The number of plugs I have to remove because of foreign body sensation is probably one in ten or less.

So, one has a choice between punctal plugs, intracanalicular implants, or cautery. Of those choices, I find that punctal plugs are the least invasive, safer, and easier to remove if the need arises.

[SusieD]

mmm but all the rest of its faults dont quite make up for it! We dont have to pay but if it but if it falls out we have to wait months for another appointment!

Not strictly true - once you've had your initial consultation - it doesnt take long at all to get subsequent appointments - they offered me an appointment within a few days when I called and said my plug had fell out and was having problems with other one.

I would have felt a lot more peed off if I had paid £120 for them.