Question about punctum plugs

[shells]

So, finally after 5 months post-lasik my lasik docs actually took the time to do a schirmer's test and confirmed that I am not producing enough tears. They put in some kind of temporary plugs that are supposed to dissolve after 10-14 days. I think they are gone by now, because my eyes aren't feeling so hot, and they did feel pretty good for a few days after they were put in. They want me to pay to have the permanent ones put in (figures they want to take even more of my money!!!), so I went to another doctor that actually takes my insurance, and the plugs would be covered there. However, she wants to do another kind of temporary plug that lasts for about 3 months. I have a few questions about the different plugs:

Are the temporary ones as effective as the permanent ones? I've heard that once they begin to break down tears can get around them and they won't provide as much relief as the permanent ones. I want them to be in there for the WHOLE 3 months so that I can get through this winter easier. I'm only around 5.5 months post-op, so there still is a chance that I could start producing more tears, and in that case, they can remove the permanent ones, right? Has anyone been through that? Is it not recommeded?

Also, I'm on Restasis and it says right in the instructions that results were not shown in patients with punctum plugs. Do they just have to put that on there because they weren't in the study, or is there actually something about using the two of them together that doesn't work?

Oh...I forgot to mention one more thing. They are only going to do lower plugs. Thanks for any ideas or for sharing your experience! I appreciate it!

Michelle

[jcorbett]

Shells - go to the section for the posts on plugs and you will find a lot of information.
As far as Restasis goes, there have been a lot of people using plugs who have got great results with Restasis. I would certainly give Restasis a try if it were me.
I believe they make plugs that last as long as 6-9 months. Perhaps you could research those and ask your doctor about it. Sorry....don't know the brand name.
I would also look at the costs of both temp and permanent plugs and see if that matters. I assume you have to pay part of the costs, even with insurance. If the costs is astronomical with permanent, it might not hurt to try the temp. You are correct, your eyes could still heal more and start producing plugs. I wore plugs for the first year after Lasik. I had permanent ones, ones with the little plug that sticks up. It didn't bother my eyes and I felt safer with it.

[shells]

jcorbett,

Thanks for the information. You know, I've been searching these boards for weeks, and I never even knew there were all those different sections on specific topics! Anyway, from what my doc said, it sounds like I only have to pay the $20 copay for temporary or permanent ones, so I guess I lucked out there with insurance. I'm still confused as to what to do though. I do like the idea of the permanent ones with the little plug that sticks up though. I read some bad things about the plugs just disappearing and having to flush them out and stuff! I like the idea of knowing exactly where they are! Perhaps my doc will have more information on the effectiveness of the 3 month temporary ones. I'm pretty sure that was the longest temp plug that they had in the office there. Thanks again!

Michelle