Silicone Versus Collagen Plugs for Treating Dry Eye: Results of a Prospective Randomized Trial Including Lacrimal Scintigraphy

To compare the short-term efficacy of collagen and silicone plugs for treating dry eye using quantitative lacrimal scintigraphy. Prospective randomized clinical trial. In this institutional study, 24 dry eye patients were evaluated in two groups: group I (n = 22 eyes) received collagen plugs and group II (n = 26 eyes) received silicone plugs. Comparisons were made with normal control subjects (n = 22 eyes). Data for the Schirmer I test, tear break-up time, and ocular surface staining with rose bengal dye were recorded before and after punctal occlusion. Lacrimal scintigraphy was performed at each time point, and the time to half maximum activity on the ocular surface (T 1/2), and the percentage retention of activity on the ocular surface at the end of the dynamic study (RI) were recorded. In both patient groups, Schirmer I results, tear break-up times, and rose bengal staining scores improved significantly after plug insertion. Mean T 1/2 values and RI values increased significantly in both groups ( P < .0001 for both). The differences for these values between groups I and II was statistically insignificant ( P > .05). Collagen and silicone plugs both resulted in significant increases in aqueous tear volume, half-life of nuclear material on the ocular surface, and percentage of nuclear material retention. The groups’ post-insertion values for all parameters were similar. These results suggest that these two plug types have similar efficacy as treatments for dry eye in the short term. Further studies evaluating long-term results are required.