dissolving collagen plugs ? how good do they work? i dont notice a lot of difference?

[jenny2008]

my upper left puncta just doesnt want to hold a reg umbrella plug anymore-they fall out, rub my eye etc... well today my doc had me try a dissolvable collagen one and i seriously can only tell a tiny bit of difference (of course now my left eye is always my worst).. anyway, i was wondering how soon after the collagen plug is put in does it expand and work as good as it is going to? does it take a few hours, a day or so???? thanks for answering!!!

[bvendig]

i had temporary plugs put in lower (the kind that last up to 3 months) and they hardly helped at all.
in the past i've had 'regular' plugs which helped a lot (i won't bore you with the details of why i'm using the temporary ones now)
but..i have a little bit of suspicion that the temporary ones are not quite the same as the regular ones.
hugs, betty

[jenny2008]

thanks for your response... yes my doc acted as if they would help more than the umbrella type as they are intracellular? maybe for some people they do? i am hoping when i go back in 3 weeks he will go ahead and do the cautery as i requested... he is so hesitant and i don't understand why..

[spmcc]

I believe I was told that the largest size of dissolvable plugs made is .5mm. Most puncta are larger than that.

I never got any benefit from 3-month dissolvable plugs in my uppers (I got approx 5 pairs... I even had two plugs put up one canaliculus at the same time!). When I was finally measured, my puncta were .7-.9mm.

I ended up getting cautery of my uppers (the lowers were already cauterized). Some doctors really balk... they think it's too drastic, I guess. I ended up hunting down a doctor who was fine with it and travelled to get cautery of my uppers. But they re-opened and I had to go back again to get another cautery! It's always a gamble... and it isn't permanent for me (but better than plugs)!

Good luck.

[jenny2008]

thanks i appreciate your response... well my doc said if this didnt work for me he will cauterize it..i go back in 3 weeks.. i really hope he meant it... ughhh..:P

[MBC]

Hi spmcc

Hi, can you tell me more about the cautery. How painful was it? My doctor really wants me to have it but tells me it is quiet painful

[indrep]

Jenny,
Collagen plugs expand almost immediately to occlude the lacrimal system. They also dissolve rather quickly, 2-3 days. This is obviously not enough time to notice clinical results;however, there should be a tear lake along your lower lid margin and eye.

[spmcc]

Hello MBC,

I've had cautery about 8 times (starting back in the 1990s when my dry eye began). I had 3 cauteries on my lowers last year and 2 so far this year. In May, I had one lower puncta sutured shut and the other three re-cauterized.

Most of my cauteries were done after injection with a local anesthetic. The worst part is the injection... after that, you don't feel anything. It's hard to say if you will be okay with the injection... I have no idea. It's doesn't bother me... it's pretty quick and when it's over, no problem.

I had cautery of my uppers in Feb this year without a local. It's a pretty quick burning sensation with some pain... then it's over. The doctor who cauterized me in Feb said the goal is to stay very superficial. That way if it needs to be reversed it is relatively easy. Unfortunately, my body has reversed all of my cauteries on its own.

I would like to mention that I've also spent years with many different plugs (dissolvable, silicone/permanent, and intracanalicular). I usually recommend that people test plugs first (lowers then lowers + uppers) to see how they do. I got no relief from plugs and got an infection after getting intracanalicular plugs. I found cautery to be the only thing that has helped me (plus wearing moisture chambers 24-7).

Good luck.

[alisonW]

Another ? for you spmcc....

You mention that you got an infection from the intracanalicular plugs and I'm curious to know what the symptoms of that infection were. I now have that type of plug in both of my lower puncta and my eyes have been more irritated then usual since I had them put in. I'm wondering if maybe that's what has happened to me. Any info or advice would be appreciated. Thanks!

[spmcc]

For me, the infection started the day after I got intracanalicular plugs in my upper puncta (I already had intracanalicular plugs in the lowers for 6+ months without problems).

It was very noticeable to me... I *never* have discharge in my eyes, but you could "milk" my puncta. In other words, if you pressed gently on the canaliculus, a white liquid would come out the puncta.

I got the plugs flushed with vigamox and saline and was put on vigamox drops. It cleared up very quickly with that.

[jenny2008]

indrep-my doc told me the plugs would last 2-3 weeks? ii am so confused... I got it in yesterday and my eye is ext dry-it hasn't helped one bit. are there plugs that last a few weeks??

[patrick]

Hi,
Are plugs only useful in case you're water deficiënt? Or can they also Be of Any help in case you have Mgd?
I have Mgd and i am looking for long term relief for it.
Any input welcome of course!

Patrick...