what kind of plugs do you have?

[atta]

Hi,
Does anyone have smart plugs? (Invisible outside, 1 year. Cost about 250 Dollars) I've been having smart plugs for about 2 years and I'm still having severe dry eyes (They are inside), my doctor insists that they are better than those classic plugs (with caps) but I'm wondering if classical plugs would help me more. They are much more expensive (for 3 years, cost about 350 Dollars).
I want to try them but I want some advice first.

[bassfan]

The main benefit of the smart plug style plug is comfort. Not having that cap protruding is the only way some can be comfortable. Advocates of capped plugs like the fact that you can easily remove a plug if necessary and you can tell if its still in easily. Ones without plugs sometimes stay in you forever supposedly if they arent the dissolving kind. I think capped plugs are more popular for that reason.

Ive had both, but prefer the capped plugs just because I can tell that they are there and that I can remove them if necessary. Take a look at Eagle Plugs (superflex is my fave). I get the feeling they have put the most technology into their designs. I also get the feeling that a lot of docs can get a certain brand cheaper than others so they push them on patients harder ($$)...plus a lot of people dont actually know anything about plugs. Try different sizes until you find one that both stays in and is relatively comfortable. If you do get capped plugs, keep in mind that they will probably be uncomfortable for a couple days but that usually goes away unless they are just too big to begin with. I could only notice mine when I look far left or right and my pupil passes over the cap.

Probably a lot more to know, those are my random thoughts for the moment...hope it helps

bassfan

[Rebecca Petris]

Atta, I agree with bass. But a caution. If you already have smartplugs be careful about getting more plugs, unless you have the original ones irrigated out and are quite sure that they are in fact out.

Many doctors have insufficient appreciation of the risks of silicone or other durable plugs getting lodged somewhere they shouldn't. I've even heard a corneal specialist, from a podium in a dry eye patients meeting, describe plugging someone with smartplugs, putting another pair in a year later, and then cauterizing the same patient a year after that with apparently no qualms whatsoever about what could happen to those plugs in the canaliculi. I was frankly appalled. The oculoplastic surgeons who deal with the complications this can cause are the ones who best understand why re-plugging when you've got intracanaliculars (including smartplugs) is not a good idea.

[kitty]

Are you sure that the plugs you have are the proper size? Do you have all 4 punctum plugged? If not on either of these fronts, I would address these before trying different plugs. I have Herrick intracanalicular plugs and have had no problems with them. I even had one irrigated out without too much hassle.

[Judy]

I agree 150% with Rebecca; be absolutely sure your smartplugs are removed before any type of new plugs are applied... Speaking from experience...

[indrep]

Atta,
The silicone plugs in theory should not be more expensive. Reimbursement is for punctal occlussion and the insurance companies make no distinction for the plug used. Also someone who uses silicone plugs should size your puncta with a sizing instrument before inserting a plug. This insures patient comfort and long term retention of the plug. It also insures no damage will be done to the punctal ring in case you need to replace the plug.

I would be reluctant to have the smart plug irrigated just yet, might try having upper plugs put in first. Perhaps the Extended Duration type.

[atta]

Hi

Hi,
Thank you for the information.
I had 4 plugs once. Extended plugs (oracle I think) for 3 months. Since I complained about the dryness my doctor plugged lower punctual twice, with different size, and then he said the plugs might be too deep to work.
Last time as I plugged smartplugs, the doctor has washed my punctuals through.
My eyes are extremely dry, sometimes I just have no tear anymore. I'm thinking a little irritation from the small caps might give me some tear, and might help in my case.
(I've always had more tears in the first week with extended plugs, when I could feel them. So I like the feeling that my punctual is stuffed. )