Plug Removal Relative to Nerve Regeneration

[Cali]

I have plugs in my lower ducts - they don't bother me much "physicially." They do bother me "psychologically." I worry they are stretching out my ducts and that they will never return to normal size, that I may get a bacterial infection, they are creating a toxic soup on my eyes, etc. I am using serum drops 75%, 8x/day. I am improving. I see my doctor again in 6 weeks.

Also, I've read that using the serum results in significant increase in the corneal subbasal nerve plexus (so the nerves may regenerate, I'm a LASIK dry eye person). My thinking is that if I have a chance at nerve recovery, I'd like the nerves to grow back as normal as possible and the plugs may act as a "crutch" causing the nerves to grow back relative to the crutch: http://kenes.com/iser2012/abstractcd/pdf/O320.pdf

I'd like to be able to live my life normally without plugs if possible.

I'm wondering if I should risk removing the plugs in 6 weeks if I'm improving. Or, are the plugs aiding in my recovery and I should keep them in as long as possible?

[Rebecca Petris]

If it were me I would not consider taking them out unless/until I was doing really well, really consistently for a considerable time - unless I and my doctor were convinced they were in actual fact making me worse (as opposed to they "might" in some way do me some harm). I think perhaps you need to start letting go of some of the "mights". There's a lot of mights in life but it's not helpful to worry about them especially the least likely ones. Actual problems are enough to deal with without more hypotheticals

FWIW I've never heard of the idea that having plugs could affect nerve regrowth.

[littlemermaid]

Cali, We are dealing with a bit of a toxic soup due to rosacea skin problems and use antibacterial eyedrops to help with mgd when the skin flares up, and frequent tear substitute drops, mostly just saline, which keep the surface flushed.

LM normally has lower plugs and I think they are a big help keeping the eye surface good and spiralling to healing by making a decent protective tear film. After a bad skin flare, predictably, we just had infected tear ducts, whipped out the plugs pronto by an experienced super-doc (no messing), and used a fluoroquinolone antibacterial, which was a very quick fix.

Just saw Doc 1 again about management and we are looking forward to putting lower plugs back in soon when we're sure the infection is gone, subject to keeping the rosacea skin good. Without the plugs, there's a lot less protective tear film and a scary dry surface even with the same daily eye regime of drops and hygiene.

Re stretching the punctum, she was 0.6mm plugs, quite big for a young person, and they were really bunged in originally to avoid dropping out, so I'll post up whether they've stretched. Doubt it. As Rebecca says, plenty more to worry about. <hug>

Re de-enervation, I think the dry surface is becoming less sensitive without plugs, there's not enough tear prompt and that we are slipping backwards. I think for us it's the tear film with plugs that's healing the eye surface and allowing it to become sensitised again.

[Cali]

Ahhhhhhhh, thanks littlemermaid. That makes sense to me, that the plugs would help in re-sensitiving the cornea surface. I too have roscea.

[Ccoughlin]

Hi Cali,
I'm a Lasik dry eye sufferer too. I'm 5 months along - - this is disappointing, but I know I just have to keep calm and hope things will improve. How far along are you? I got plugs too. They seem to have helped some, but I still have bad dry eye and don't see well (it's blurry when my eyes are dry) in low-lighting, night driving, etc., which is really frustrating. Did you decide to keep your plugs? When do the nerves regenerate from Lasik?

take care - chandra

[bbga]

How did they take your plugs out? Were they surgically removed? Where they intracanalicular plugs or the kind that can be easily removed because they have an end piece to grab hold of? What state do you live and who is your super doc?