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The most common size plugs are the 0.6mm and 0.7mm.
You should gauge both patient’s puncta prior to choosing which size plug(s) to use. Use an appropriately sized plug for each puncta. Please refer to the instructional video for further information.
You can use the Coroneo Punctal Gauge to determine the appropriate size plug for each puncta. This gauge is a reusable double-ended instrument that allows you to gauge the size of the puncta from 0.5mm to 1.0mm. Please refer to the instructional video for more complete instructions on gauging. Watch the video here.
Plugs are considered a permanent treatment for dry eye; however, they are easily removed if desired.
Plugs are provided sterile on an inserter/dilator. You may apply a topical anesthetic to the area prior to insertion if desired. After you have gauged the patient’s puncta and determined the appropriate size plug to use, the plug insertion instrument should be held like a pencil, using the dilation tip to gently dilate the puncta prior to inserting the plug. Rotate the instrument 180 degrees after dilation and gently insert the plug into the puncta using a slight rotating motion from side to side by rolling the insertion instrument between your thumb and index finger. When the plug is in the puncta and the rim of the plug is seated flush with the lid margin, depress the release trigger to leave the plug in place in the puncta. For further instruction on this procedure please refer to the IFU included with the plugs and watch the instructional video. Watch the video here.
The plug should be removed using appropriate fine forceps (i.e. fine curved or jeweler’s type forceps). The plug should be grasped around the vertical shaft of the plug below the rim (never grasp the edge of the exposed rim, this may damage the plug) and gently apply traction until the plug exits the puncta. For further information please refer to the instruction video. Watch the video here.
The plugs are supplied in a box with two single sterile units preloaded on an inserter/dilator.
You may insert plugs into any puncta, however the majority of plugs are inserted into the inferior puncta.