The eye moisturizes with tears all the time to keep its function. Blinking results in constant lubrication and the front surface of the eye is always moist. It is normal for excess tears to flow into the nose. It can sometimes happen that there are so many tears that the system cannot take so many tears and excessive tearing occurs.
Closed or obstructed lacrimal pathways are most common in infants or later in adults after 50 years of age.
In patients with tear passage impairment, secondary infections and purulent contents often occur in the inner eye corner. After local anesthesia, a tear duct probing is performed to ensure flow and thus reduce the incidence of infection. The procedure must sometimes be repeated several times.
Punctal occluders are specially designed plugs that are implanted into drainage tear ducts to reduce the flow of natural tears. They can be placed in the lower eyelids puncta, and in more severe cases in the upper ones. They are used in severe dry eye syndrom forms.
Tear ducts probing is performed when tears cannot be drained normally, leaving watery and irritated eyes. Often the cause is infection, inflammation, tumor or injury.
The procedure is performed by widening the tear ducts or by penetrating the membrane located in the middle of the tear drainage system and preventing the normal outflow of tears from the eye to the nose.
The procedure is performed under local anesthesia with drops.
Before probing, a specialist examination should be performed, informed consent signed and the local anesthetic applied into the eyes.
During the probing, the patient sits comfortably in the operating chair. The procedure only takes 5-10 minutes per eye.
Recovery after tear ducts probing is rapid. The patient goes in after half an hour. Check up examination is scheduled the next day. The patient receives appropriate therapy and instructions after the procedure. It is recommended that the area in which probing was performed should not be rubbed or pressed (do not splash with water, do not wipe with a towel or do hard physical work).
Punctal occluders are used for the hyposecretional dry eye form of different etiology, such as:
• In autoimmune diseases
• Involuntive change
• After laser refractive surgery
• After irradiation
• After a tear gland surgery
No special preparation is required before the procedure. The procedure is not painful, but anesthesia is applied to the patient to make it as comfortable as possible.
During the procedure, the patient is in a supine position. Punctal occluders are placed accurately under the operating microscope. The procedure only takes a few minutes per eye.
After the implantation, the patient goes home. It is advisable not to rub your eyes very hard in the future because of the possibility for the occluder to fall out of the place.
The implantation procedure takes about 5 minutes in the operating room. The patient lies down and the implantation is done under an operating microscope. Anesthesia is usually not needed or is given in the form of eye drops, to make the procedure even more comfortable.
Punctal occluders differ in the type of material they are made of, the size and duration.
This is a minimally invasive procedure. Consult a specialist doctor before surgery.
The punctal implants are positioned superficially. The advantage is that they are easy to remove, but more care is needed when washing and manipulating the eyelids so that the implant is not accidentally removed. If this happens, it is not dangerous, the process is easily repeated.
By the type of material, punctal implants are divided into temporary (collagen) which are resorbed after a certain time and the procedure needs to be repeated. The other category are those lasting ones (silicone and advanced (SmartPlug, Oasis FormFit, Eagle “Flow Controller”)). They change shape and volume depending on the external conditions (temperature, humidity). The size of the implant varies from 0.2 – 1.0 mm, and precise measurements are needed to individualize the appropriate size.
The cost of implantation of a punctal occluder is 750 kn per eye. See our price list for all current promotive actions.
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Poliklinika Knezović
Green Gold Business Center, Tower V1, 8th floor
Ulica grada Vukovara 269f
10000 Zagreb
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