A comparative assessment of punctal plugs versus artificial tears for treating dry eye

Introduction: Dry eye disease (DED) is a multifactorial disorder of the ocular surface characterized by tear film instability, ocular discomfort, visual disturbances, and inflammation. Artificial tears are the most commonly prescribed first-line treatment, whereas punctal plugs provide a longer-lasting approach by reducing tear drainage. This study attempted to compare the efficacy of punctal plugs and artificial tears to prevent DED. Material and Methods: A prospective, observational comparative study was conducted among 39 patients diagnosed with mild, moderate, and severe DED, where 20 cases for punctal plugs and 19 cases for artificial tears were selected. Clinical outcomes, including symptomatic score, ocular surface disease index, Schirmer's test, tear break-up time, and corneal fluorescein staining, were assessed at baseline and after 3 months of treatment. Results: Both treatment groups demonstrated significant recovery in symptoms and tear film parameters. In the present study, punctal plugs and artificial tears have a remarkable enhancing effect on improving symptom score and DES parameters in post-treatment. But there was no statistically significant difference between the two groups. No major adverse effects were obtained. Conclusion: In the present study, punctal plugs and artificial tears had a remarkable preventive effect on improving symptom scores and DES parameters in post-therapy. But there was no statistically significant difference between the two groups. This study suggests that punctual plugs do not play a role in forming tears, but it surely helps to prevent DED by blocking the tear drainage pathway and holding the natural tears in the eyes for a longer period.