Restasis and punctual plugs?

[Eyeproblems]

I am scheduled to see a doctor in a few weeks about plugs or caudery (however its spelled) I noticed doing my restasis research that restasis did not help those with punctual plugs.

Is anyone with plugs using restasis? Do both actually help?

Im seeing two different eye specialists although both know im seeing the other, one favors restasis the other plugs/caudery. I personally prefer using my natural tears then the restasis with side effects, but im curious since the one doctor wants me to keep on the restasis is their any point?

Anyone speak from experience? Your input would be greatly appreciated.

[pecan121]

I used Restasis when I had all 4 ducts plugged. I didn't think the Restasis was doing anything until I stopped using it. Then someone on this board suggested using it 4 times a day instead of 2. I did notice an improvement then.

Now I have both lower ducts cauterized. One plug was removed because it wouldn't sit properly because of scar tissue. I saw so much improvement that I had the second one removed as well.

I am still using Restasis 4 to 3 times a day and don't plan to stop. I am a Sjogren's patient and what works for me might not be necessary for you. I still have flares like everyone else, but I feel cautery and Restasis have really helped.

[Eyeproblems]

Thank you for your reply.

I noticed others who use restasis plus plugs, the website I was reading stated people already with plugs and using anti inflammatory meds would not see a difference.

However it appears to not be accurate.

I dont want to start another thread but I am a little concerned about restasis and maybe someone could comment.

I am reading alot of horror stories and user feedback on other sites. Mainly complaining of infection, colds, sinus issues on restasis. Blaming this on cyclosporine being an immune suppressant.

I am quite concerned about this, since they all apply to me. Before starting my eye that has been battling reoccurent infections and which i just had cleared up but now it seems to be showing signs of infection again, also a co-worker commented yesterday asking me if i have another cold because i sound bad, stuffed up and nasally.

Is this a legitimate concern, i know cyclosporine lists these as side effects taken orally but what about restasis applying it to your eyes. People are reporting these issues, and its scarry especially knowing i have had these issues in the past.

I dont know if i should continue on or not.

[nahzee]

If restasis is going to work for you, it should work the same with or without plugs. I would theorize that you might get a slightly higher dose with plugs in than without.

Ultimately, the difference between the castor oil control group, and the amount of patients who experience improvement on restasis, is 10%. If you understand that it is truly a long shot, but if it works, it may work very well for you... then give it a try.

[Guest]

If restasis is going to work for you, it should work the same with or without plugs. I would theorize that you might get a slightly higher dose with plugs in than without.

I agree with your theory... the plugs will keep the drug in the eye longer, since it can't drain out like on a plug-less person. I also theorize that having plugs might increase the irritation from Restasis because of this longer retention time... this is nothing I've read anywhere, just my own suspicion... that being said, I think if one were to use a drop of artificial tears 15 minutes afterwards, it would help rinse out any leftover Restasis for those of us with plugs who are experiencing a lot of irritation from the Restasis... Just a theory though...

Ultimately, the difference between the castor oil control group, and the amount of patients who experience improvement on restasis, is 10%. If you understand that it is truly a long shot, but if it works, it may work very well for you... then give it a try.

On this note, I had read that Restasis usually wasn't effective enough on it's own for those with severe dry eyes...if I recall correctly, it was most effective for those with mild to moderate dry eyes. Not saying it's not worth using if one has severe dry eyes... just that a severe dry eye person would likely need more then just Restasis to get sufficient improvement (ex. add on plugs, oral tetracyclines, maybe secretagogues like pilocarpine etc etc.)

[Guest]

Is anyone with plugs using restasis? Do both actually help?

Im seeing two different eye specialists although both know im seeing the other, one favors restasis the other plugs/caudery. I personally prefer using my natural tears then the restasis with side effects, but im curious since the one doctor wants me to keep on the restasis is their any point?

Anyone speak from experience? Your input would be greatly appreciated.

I was leary at first when it came to using Restasis... finally decided to just go for it... I've now been on it 4 times daily for a little over a year... I'm sure it's helping though... prior to Restasis my eyes used to flare up for no apparent reason... since Restasis, that no longer happens... my eyes are more on an even keel from day to day... now, if they flare, I always know why (ex. more computer time than usual, went without goggles at a wedding etc.)

Maybe one day when I'm certain that I've plateau'd for good, I'll try going off it to see what happens... but things are so good right now, I don't want to risk messing that up! (maybe not good compared to a normal person, but fantastically great compared to 2009!!)

Mind you, I'm not getting eye infections... It sounds like you are getting them? What does your doctor say about that?? That would concern me also...

[fundryeyes]

Although I've read some people get relief from plugs, it seems many many more have issues with them. My ophthalmologist and optometrist won't touch them because of all the problems with them including pain, falling out, etc.. The thing that is most interesting to me is that your body will adjust to them by producing less tears when it senses the extra moistness. What a cruel bugger our body can be !!!

[Guest]

The thing that is most interesting to me is that your body will adjust to them by producing less tears when it senses the extra moistness. What a cruel bugger our body can be !!!

I've read that this might happen too. But just so people know, keep in mind that this does not mean that plugs won't help at all. My right eye has been helped immensely by having both puncta blocked (bottom with a plug, upper with cautery)... it can be positively, gloriously WET when I'm not overdoing the computer time etc.... that NEVER happened before having the plug/cautery.

Personally, I think if a doc won't use plugs at all for any patient, they are doing a disservice to their patients... granted, they won't help everyone, but patients who are good candidates for them should be given the OPTION of trying plugs.

Also, if properly fitted, one can have plugs AND comfort... I honestly don't feel mine at all, and they've been in a little over a year now, and have never fallen out, moved, or caused me any problems. I totally get that there are many people who have had trouble with them, but at the same time, I'd hate for anyone who might benefit from them to be scared to try them.

[fundryeyes]

You are right SAAG, they do help people. I think the Drs. I have do not use them for completely selfish financial reasons. There is an implied warranty when you pay them to insert the plugs, and from history they get a lot of re-do's , revisions, etc which come out of their time and pockets. The ophthalmologist actually told me "they're too much of a hassle" . I think a lot of doctors believe this about dry eye syndrome in general. This disease can be treated , although ultimately it has them licked and they are frustrated about that.

[Guest]

I think the Drs. I have do not use them for completely selfish financial reasons. There is an implied warranty when you pay them to insert the plugs, and from history they get a lot of re-do's , revisions, etc which come out of their time and pockets. The ophthalmologist actually told me "they're too much of a hassle" .

!!!

That kind of thing peeves me off... I think as in any profession, there are those who have the temperament that makes them excellent at it, and others who either fell out of love with their job, or were never all that into it in the first place and just want the "easy" cases.... sucks when the latter type is one's own doctor, that's for sure!

I can tell you from my own experience that it is worth it to keep trying until you find a doc who has the temperament that makes them excellent at it... And for anyone who has had Lasik and might feel resentment towards ALL Lasik surgeons, please try to let that go... you might find your best dry eye doc in Lasik surgeon (my current doc who I think has been wonderful with my dry eyes just happens to also perform Lasik)...

[willwork4tears]

I used Restasis and felt a benefit. But after plugs, I noticed a dramatic improvement. My opinion is that restasis didn't help the people that had plugs, because plugs helps more than Restasis ever could. The subjects' benefit was maxed out with the plugs, so adding Restasis on top of that didn't improve the subjects in a statistically significant way. That being said...even with plugs...I still used my Restasis.

I currently use 1% cyclosporine 2 times a day and I had lower cautery as a more permanent way to get around having to replace plugs every 2-3 months.

If you asked me to choose one or the other I would choose plugs. But if you're really severe, I recommend using them together.

[Pegasus]

I tried both. I used temporary plugs which did help immediately because it helps shore up what ever tear that the eye is producing. I didn't want permanent plugs because they caused eye infections for me. I am also scared about permanent cauderization.

Restasis did not help me- the more I used it, the drier my eyes became. Same thing with eye drops.

I take 400o mg of Omega Fish Oil a day, which also help to relief dry eye, on top of TheraLife Eye.

Hope this is helpful

[jads]

I would second the comment by Pegasus. Restasis is not the answer in my opinion.

To openly state in their literature that side effects from Restasis treatment are the very symptoms most of us are trying desperately to avoid just seems ludicrous.

I would also not get permanent plugs either.


Best

[willwork4tears]

I agree with others. Permanent plugs are a bad idea. I looked into Smart Plugs and decided cautery was a safer option. I wouldn't let your doctor talk you into a Smart plug or Herrick-style plug until you think long and hard about it. The silicone "umbrella" plugs are sometimes called permanent plugs, but they can be removed easily. So those should be fine. Although calling them permanent is kind of silly, because they fall out pretty easily. They should be called "potentially long-term plugs."

[msny]

I am scheduled to see a doctor in a few weeks about plugs or caudery (however its spelled) I noticed doing my restasis research that restasis did not help those with punctual plugs.

Is anyone with plugs using restasis? Do both actually help?

Im seeing two different eye specialists although both know im seeing the other, one favors restasis the other plugs/caudery. I personally prefer using my natural tears then the restasis with side effects, but im curious since the one doctor wants me to keep on the restasis is their any point?

Anyone speak from experience? Your input would be greatly appreciated.

I've used both the plugs and Restasis together, and they work
fine for me. But for me the real tipping point for dry eye
came when I added the rice baggy treatment last year.

Now using just these three treatments together dry eye
is about 100% better. Still there, but treatable.

The best thing about it, I dont need to use as much regular
wetting drops in between.