Paradoxical increase of visual impairment with punctal occlusion in a patient with mild dry eye

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• 作者：Shizuka Koh ; Naoyuki Maeda ; Sayuri Ninomiya ; Hitoshi Watanabe ; Takashi Fujikado ; Yasuo Tano ; Yoko Hirohara and Toshifumi Mihashi
• 刊名：Journal of Cataract and Refractive Surgery
• 出版年：2006
• 出版时间：April 2006
• 年：2006
• 卷：32
• 期：4
• 页码：689-691
• 全文大小：170 K

文摘

We report a paradoxical increase in visual impairment after punctal plug placement despite improvement in corneal epithelial damage caused by mild dry eye. Ocular higher-order aberrations (HOAs) were measured sequentially with a wavefront sensor before and after punctal plug insertion in a patient with mild dry eye. Although postblink HOAs tend to increase in normal subjects or patients with dry eye, after treatment there was a maximum spike in HOAs for a few seconds that decreased gradually. Excessive retention of tear film by punctal occlusion may cause inferosuperior asymmetrical distribution in precorneal tear-film thickness, possibly leading to slower wavefront on the inferior cornea and increased coma-like aberrations. Increased visual impairment might occur paradoxically despite improvement in the corneal epithelial damage caused by dry eye.