Well, I'm glad we're seeing more comparative studies and I hope they continue. I also hope we see something soon with longer-term follow-up. I will put a new subscription to Cornea on my Christmas wishlist so I can learn more about the methods and drop-out rates used in studies like this.
I've probably missed some along the way but this is the first thing I recall seeing that specifically supports the use of plugs plus Restasis.
Comparison of topical cyclosporine, punctal occlusion, and a combination for the treatment of dry eye.
Cornea. 2007 Aug;26(7):805-9
Roberts CW, Carniglia PE, Brazzo BG
In brief...
They both help, individually.
Together, they do better than either treatment individually.
ABSTRACT - from which I had to leave some parts out because this stupid blog software thinks that the >'s are HTML rather than "greater than" signs, grrr. If anybody knows how to get the blog to ignore it please let me know.
I've probably missed some along the way but this is the first thing I recall seeing that specifically supports the use of plugs plus Restasis.
Comparison of topical cyclosporine, punctal occlusion, and a combination for the treatment of dry eye.
Cornea. 2007 Aug;26(7):805-9
Roberts CW, Carniglia PE, Brazzo BG
In brief...
They both help, individually.
Together, they do better than either treatment individually.
ABSTRACT - from which I had to leave some parts out because this stupid blog software thinks that the >'s are HTML rather than "greater than" signs, grrr. If anybody knows how to get the blog to ignore it please let me know.
PURPOSE:: To compare the efficacy of topical cyclosporine, punctal occlusion, and a combination for the treatment of dry eye. METHODS:: Patients with dry eye (N = 30) seen in a university-affiliated private practice were randomized to 1 of 3 treatments: cyclosporine 0.05% ophthalmic emulsion (RESTASIS) twice daily, lower-lid punctal plugs (PARASOL), or a plugs-cyclosporine combination. Tear volume, ocular surface staining, and artificial tear use were assessed at baseline and 1, 3, and 6 months. RESULTS:: All treatments improved Schirmer scores by 6 months..., with plug-containing regimens favored at 1 and 3 months (P < 0.001 vs. cyclosporine alone). Cyclosporine-containing regimens, but not plugs alone, improved rose bengal staining at 3 and 6 months.... Artificial tear use decreased with plug-containing regimens at 1 month and with all treatments at 3 and 6 months.... Combination therapy produced the greatest overall improvements and was superior to plugs alone in decreasing artificial tear use at 6 months.... CONCLUSIONS:: All 3 regimens effectively treated dry eye. Plug-containing regimens increased wetness initially; cyclosporine appeared to promote long-term ocular surface health. The effects may be additive. Patients with punctal occlusion may benefit from adjunctive cyclosporine.