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  • Plugs and low TBUT

    I am going in to get lower plugs put in on this Wednesday. I have been on Restasis for about 3 1/2 months. I can't say if it is helping or not at this point. I have a lower TBUT, last measured at 4 & 6. I have ready that plugs may not help if quality if bad.

    Does anyone have experience with lower plugs working and a lower TBUT? I had Lasik done in late January.

  • #2
    Hi Laura,
    Lower plugs did nothing for me, but I am not you. I hope they help you! Good luck Wednesday!
    Bianca
    Lasik victim 2012

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    • #3
      hi Laura,
      I tried lower plugs - the collagen ones that solve after about a month. My tBUT is similar to yours; 4 & 6. I hardly noticed any difference with the plugs. But I've heard that people are much more satisfied with silicone plugs. I'm soon going to try silicone plugs instead of the collagen ones, and hope to notice a difference then. Strange though, because they're supposed to have the same function. Anyone who knows why silicone plugs seem to do more than collagen plugs?
      Meike

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      • #4
        Lower TBUT is due to MGD. Do you have MGD?

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        • #5
          Laura
          Low TBUT can be attributed to different issues. If your tear volume is too low that can lead to a low TBUT; if your lipid production is low then rapid evaporation leads to a low TBUT; if your mucin production is low and tears can not adhere to the corneal surface that can lead to a low TBUT. The LASIK procedure can affect all three layers of the tear film.

          Punctal occlusion will help keep more tears on the ocular surface. This should help with comfort and over time can play a role in lowering the osmolarity back to normal. When the osmolarity normalizes inflammation is minimized and the goblet cells (mucin) will increase and the meibomian gland ducts will open and secret more lipids.

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          • #6
            I appreciate your response. I have a follow-up visit this week and need to better understand what is causing TBUT to be low. Even if the plugs give me minor relief - I would be happy.

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            • #7
              I just had the plugs put in today. Is it normal to have some discomfort for awhile as eyes adjust? My eyes seem really sensitive anytime I move my eyes from the plugs.

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              • #8
                Originally posted by LauraK View Post
                I just had the plugs put in today. Is it normal to have some discomfort for awhile as eyes adjust? My eyes seem really sensitive anytime I move my eyes from the plugs.
                you will getused to it. I have 2 lower plugs, hardly can feel them anymore

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                • #9
                  Hi, I have had all four silicon plugs for over three years, I have only lost two in all that time, I have a bit of feeling from the left eye due to the fact that my lids on that side tend to roll "in" a bit causing the plug to make more contact on the eye but that too is now very minimal. When I first got "plugged," it was just the lower two and it helped a bit but it wasn't until I got the upper ones in that it helped alot. I had LASIK myself which caused all this and I can tell you that I can not live without the plugs, they were the single most help for this condition I ever got to date. I am currently in a study using autologous serum drops but two weeks into it I developed a severe allergic reaction and it took a week of steroids to get back to my "normal." Good luck to you and hang in there, I think you will find the plugs very helpful.

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                  • #10
                    Thank you for your response. I am actually taking the serum drops and not sure how much they are having. What kind of reaction did you have to them? I have had some stinging and burning sensation when I have used them, but not all the time. I would think there would be minimal allergic reaction since they are own serum.

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