From the Guidelines
Punctal plugs can remain in place for many years without complications, provided they are appropriately sized, with 56% of silicone plugs retained after 2 years, as reported in the most recent study 1. The duration that punctal plugs can remain in place depends on several factors, including the type of plug, the material used, and the patient's individual characteristics.
- Temporary dissolving plugs, typically made of collagen, usually last 3-6 months before naturally dissolving.
- Semi-permanent silicone plugs can remain effective for years if not dislodged or removed, with some studies suggesting that they can be retained for many years without complications, as long as they are properly sized 1.
- Permanent plugs are designed to stay indefinitely, but may require surgical removal if complications arise. Key factors influencing the longevity of punctal plugs include:
- Material: Collagen dissolves faster than silicone, which can last for several years.
- Patient's tear production: Plugs may need to be replaced or removed if the patient's tear production changes over time.
- Complications: Migration, extrusion, or infection can require earlier removal of the plug. Regular follow-up appointments with an eye care provider are necessary to monitor the plugs' position and effectiveness, and to address any potential complications that may arise 1. Some patients may experience minor irritation, excessive tearing, or infection requiring earlier removal, and the choice of plug duration should match the patient's specific dry eye condition severity and underlying cause.
From the Research
Duration of Punctal Plugs
- The duration that punctal plugs can remain in place varies depending on the type of plug and individual patient factors 2.
- Temporary collagen plugs are designed to be short-term and may last for a few days to a few weeks, with some studies showing they can be effective for up to 90 days 3, 4.
- Silicone punctal plugs, on the other hand, are designed to be longer-term and can last for several months to a year or more, with some studies showing significant improvement in dry eye symptoms at 2,6, and 12 months after plug placement 2.
- However, plug retention rates can vary, with one study showing that a majority of patients with ocular graft-versus-host-disease (oGVHD) spontaneously lost their punctal plugs within 90 days of placement 2.
- Regular follow-up after plug placement is recommended to detect plug loss and ensure adequate disease control 2.
Factors Affecting Plug Duration
- The type of plug used, with temporary collagen plugs having a shorter duration than silicone plugs 3, 4.
- Individual patient factors, such as the severity of dry eye disease and the presence of ocular graft-versus-host-disease (oGVHD) 2.
- The skill and experience of the healthcare provider inserting the plugs, with proper technique and aftercare important for maximizing plug retention and minimizing complications 5.