How do they "irrigate them out?"

[calli66]

(I posted this to Dr. G also)

My retina doctor once again asked me why I haven't gotten plugs. My answer was that the temporary collagen plugs the cornea doctor put in (tried twice) didn't seem to do much, and he charged $295 USDollars per eye to do it.

She offered to insert plugs just for the cost of the plug, so now I am seriously considering a plug for my left eye. She mentioned "Oasis." But if it has to be removed, what is the procedure? Does it get forced out with the saline-- into the main lower duct and into the nasal passages?

And Dr. G, here, recommended the Parasol from Odyssey. Does the head of that plug stick up and interfere with contact lens-wearing?

C66

[indrep]

Cali,
OASIS makes silicone plugs which have a flange that rests on the punctal ring. This plug is a low durometer level of silicone (very soft) and has a low profile flange to minimize foreign body sensations. This plug is easily removed with forceps.

OASIS also makes an intracanalicular plug the Form Fit. This plug is a hydrogel material and when hydrated it is 90% water. To remove this plug it needs to irrigated. Upon irrigation it elongates and shreads like mucous.

I hope this helps.

[kitty]

Calli, if you would like a bit more info about the irrigation of intracanalicular plugs, I would be happy to share my experience. Just PM me.

[calli66]

Thanks to everyone--I guess I'm leaning more toward the visible type plugs, but don't have any good reason for that choice except the fear of having the intracanalicular kind stuck and causing problems. There are so many stories about all the different kinds.

I'm entering unknown territory.

But my left eye has gotten so dry that, while it doesn't feel too terrible, the center of my contact lens goes opaque--not hydrated. I'm hoping a plug might improve that.

C66

[Guest]

C66

I have had several rounds with Oasis intracan....blah.blah.blah (can't spell it), mine were simply referred to as the 90 day dissolvable plugs.

I never had mine irrigated out, they simply dissappeared (so my trustry refractive surgeon told me), and I believed him (what must I be thinking).

After about 4 trials of the dissolvable plugs, we opted for Oasis permanent plugs. The top ones were hideous,they kept hitting my corneas when I looked in just about any upward direction. So I insisted they be removed and have just settled for lower plugs now.

I like them in the fact that I can see them (when I look in the mirror) and am comforted by the fact that that they are not travelling merrily through my nasal system finding an express route to my lungs. (I have no idea where they end up but I am not prepared to take any more risks).

They are very comfortable and I wouldn't even know they are there most of the time, however, I occassionally look and "discover" them via a sharp pain in my eye.

I don't know the cost of them (I have never paid for them) but would recommend a trial with the more permanent plugs.

There are lots of stories here with different experiences to plugs. I found that the lower two permanent plugs are far more effective than all four temporary plugs were.

Just my thoughts.

Regards

Ian

[indrep]

Calli,
I apologize I didn't really answer the "How do you irrigate them out?"

Generally a a 23g open ended cannula is used with BSS (Balanced Salt Solution) to irrigate the plug out.

I would opt for the silicone first. It is much easier to remove should the need arise. As Ian said you can always see that it is there. Generally speaking I feel the intracanalicular plugs are for those that can't tolerate the silicone or can't seem to keep them in place.

[calli66]

After about 4 trials of the dissolvable plugs, we opted for Oasis permanent plugs.

Is this the permanent plug? http://www.oasismedical.com/Products...View.asp?id=27
Thanks for the help and information.

C66

[Julie1]

Flow controller plugs

Ian,

Have you thought about trying upper flow controller plugs (made by Eaglevision)? I have them and have found that they are good compromise between the dryness of only two plugs and the wetness of all four plugs. Nothing will ever take the place of having a normal tearflow, but lower plugs plus flow controller plugs have helped me quite a bit. The tops of the flow controller plugs are flesh with the skin, so I can't even feel them. They do not scratch the sclera at all!

-Julie

[indrep]

Cali, yes

those are the permanent silicone plugs from OASIS.

[Guest]

Is this the permanent plug? http://www.oasismedical.com/Products...View.asp?id=27
Thanks for the help and information.

C66

C66, Yes they are the ones I have in the lower now.

Julie1, I haven't tried the flow controller plugs, thanks for the suggestion. Will discuss it with the DR next week, not really sure if I need upper again, as seem to be more manageable days than not. My worst dryness is nighttime and on waking.

Cheers

Ian

[calli66]

Puncta too Tiny

At my checkup today I decided to ask my optometrist if she did plugs--and the answer was yes. She didn't have the Oasis silicone type, but did have the Parasol (Odyssey).

The Parasol size "small" was apparently too big--she said my puncta were really tiny--the plug wouldn't fit. She tried dilating the hole, but it didn't help. She said she would order the Oasis silicone plug in the "micro" size.

I'm not sure if I'm doing the right thing--having the optometrist rather than the ophthalmologist inserting the plugs. I guess I should have asked how many times she's done it, but I trust her for everything else, so I don't get the feeling she'd do something wrong.

But---IS there a chance of damage to the punta during inserstion?

What questions should I be asking?

Thanks

C66

[kitty]

The procedure is quite safe. If your doctor decides to dilate (stretch) your puncta to make insertion easier, there is a remote chance that the puncta could be torn. Just be sure to ask her about all of the risks before you agree. Between my temporary, semi-permanent and permanent plugs, I have had plugs inserted more times than I can count. The only problem I had was with a plug falling out by the time I got to the car. I did have a puncta dilated because it was tiny. Forcing the plug in there did cause plug irritation and I had to have that plug irrigated out. Just remember, docs have been inserting plugs for many many years and most go without problems.

[Danny_]

Mine are permanent oasis ones. They don't irrigate them out. They just take them out with a tweezers. You have to sit still and trust them though. It's relatively painless although once, I got jabbed in the eye at the very start and that hurt like hell but not since then.

[calli66]

Got plugs today!

The doctor got me the micro-mini-teeny-tiny Parasol (by Odyssey)--and they fit! The left one was harder to put in (tinier punctum) but she managed it.

So, my First Plugs. An initiate into Plugdom.

I definitely don't have the epiphora problem; they feel pretty comfortable, and----I'm hoping maybe a little more tears will stay in my eyes.

Thanks to everybody for their help and advice.

C66

[indrep]

calli,
congratulations I hope it goes well for you.

Less than 2% of people have puncta your size.