Rheumatology International

, Volume 33, Issue 10, pp 2543–2548 | Cite as

Punctal plugs versus artificial tears for treating primary Sjögren’s syndrome with keratoconjunctivitis SICCA: a comparative observation of their effects on visual function

  • Weiqiang Qiu
  • Ziyuan Liu
  • Mingxin Ao
  • Xuemin LiEmail author
  • Wei Wang
Original Article


To compare the effects of treatment with punctal plugs versus artificial tears on visual function for primary Sjögren’s syndrome with dry eye. Forty-two eyes of 42 patients with primary Sjögren’s syndrome were enrolled and were allocated randomly into artificial tears (AT) group and punctal plugs (PP) group. Ocular Surface Disease Index (OSDI) was used, and fluorescent staining for tear film break-up time (BUT), the Schirmer test I (STI) and contrast sensitivity was performed before treatment and was repeated 3 months after treatment. A follow-up of 3 months was achieved in 40 eyes of 40 patients, including 19 eyes in artificial tears group and 21 eyes in punctal plugs group. Statistically significant improvements were observed in the OSDI scores (AT: 52.6 ± 5.7, 15.9 ± 4.2; PP: 55.8 ± 4.9, 15.1 ± 4.2), corneal fluorescein staining scores (AT: 2.60 ± 1.76, 0.30 ± 0.57; PP: 1.91 ± 1.60, 0.09 ± 0.29), STI (AT: 3.85 ± 2.03, 8.95 ± 2.72; PP: 3.36 ± 1.62, 11.41 ± 2.65), and BUT (AT: 2.60 ± 1.39, 6.00 ± 1.81; PP: 2.27 ± 1.12, 7.82 ± 1.84) after treatment compared to those of pre-treatment. The values of STI (AT: 5.10 ± 1.80; PP: 8.05 ± 1.53) and BUT (AT: 3.40 ± 1.31; PP: 5.68 ± 1.13) in punctal plugs group were significantly more improved than those in the artificial tears group. The medium- and high-level frequencies contrast sensitivities were greatly improved in simulated daylight, night, and glare disability conditions after treatment with artificial tears and punctal plugs. However, the changes in contrast sensitivity did not significantly differ between groups. Both artificial tears and punctal plugs relieved dry eye symptoms, repaired corneal lesions, enhanced tear film stability, and improved contrast sensitivity. Punctal plugs could improve tear film stability and elongate the BUT better than artificial tears.


Sjögren’s syndrome Dry eye Punctal plugs Artificial tears Contrast sensitivity 



Supported in seed fund (No. 79495-01) and Linhu fund (No. 79495-02) of Peking University Third Hospital.

Conflict of interest

There is no financial conflict of the authors in this study.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Weiqiang Qiu
    • 1
    • 2
  • Ziyuan Liu
    • 1
    • 2
  • Mingxin Ao
    • 1
    • 2
  • Xuemin Li
    • 1
    • 2
    Email author
  • Wei Wang
    • 1
    • 2
  1. 1.Department of OphthalmologyPeking University Third HospitalHaidian District, BeijingChina
  2. 2.Key Laboratory of Vision Loss and Restoration, Ministry of EducationBeijingChina

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