Flow Controller Punctal Plugs (Update)

[patrick]

Hi Patrick, Im not Ashley . I did send you a PM sometime back, remember?. Thank you for the advice. I will ask Mirjam for the letter. Best wishes

Hello minh!

So sorry for my mistake! I appologize for that.
Yes,i of course remember your pm although it was quite some time ago. Somewhere in the course of 2012?
Obviously you're still in the netherlands. Enjoying our fantastic cold spring already? Haha! Bleeh!
About my previous advise. You really should ask mirjam for the letter. It will help you getting the prescription for sure.
Good luck with that.
Curious how things went for you,so please post your update here on the forums.

Best regards,patrick..

[zuzu70]

Last week I travelled interstate to a top dry eye surgeon and he said cauterizing my HUGE punctas (due to DCR surgery) would be difficult because each 'zap' causes distortion of the puncta). So he recommended we could try 'flow control plugs' like you've tried Tankie because they manufacture a larger plug than most others. They 'may' fit my gigantic puncta. Not sure yet. I had two Duraplugs put into the huge upper and lower puncta but tears are still draining too quickly through them. So definitely need something more permanent.

DCR, could you please elaborate on what your surgeon said regarding it being difficult to close up your surgeried punctas? I'm in a similar situation as I had a rectangle of tissue removed around both punctas. I'm concerned because the young-ish doctor I'm thinking about doing my cautery says that he doesn't think my punctal snip will affect the outcome of the cautery because he cauterizes down deep in the tear tube (canulus?). I like my doctor a lot, but I'm worried that he doesn't have enough experience to know. Your surgeon's comments make me nervous. Now, granted I did not have a DCR so there's been nothing done down deep in the tear tube for me. But I have seen the photos of your huge punctas, and believe me mine look even huger, at least at the opening.

Thank you for your help. You were one of the first people to reply to my very first post when I joined the forum, so I will always be thankful for you.

[DCRdryeye]

Hi Zuzu, It's difficult to elaborate because it sounded complicated. Basically when you cauterize one side, the other side dips in and makes it more difficult to be cauterized, and it continues to a cauterized mess off flesh. Yet, another surgeon said she can cauterize and sew over it. Now the second doctor is not as qualified with dry eye patients so she maybe used to butchering flesh. So I appreciate the first doctor explaining how cauterizing could cause problems.

I get temporary Duraplugs placed into my enlarged puncta, but I know tears seep through because it's the worst dryness and the worst eye.

It sounds like your doctor is young and too confident. Many doctors only cauterize at the most superficial level, not deep down inside. Ask questions, demand answers or change doctors. It's scary and I know what you're going through. I wish I could provide you with further assistance.