A systematic review by the Cochrane Collaboration sought to assess the safety and efficacy of punctal plugs for the management of dry eye.
The review included eighteen studies, testing punctal plugs of different materials, and comparing them to other treatments for dry eye.
Overall there were mixed results; punctal plugs did not show consistent improvement of dry eye symptoms compared to the comparison group at follow-up.
[3] Some adverse outcomes from participants included spontaneous plug loss, epiphora, ocular irritation, foreign body sensation, and local inflammatory reaction.
[3] If punctal plugs are at least partly effective, thermal,[4] electric[2] or radiofrequency (RF) cauterization of puncta can be performed with local sedation.
Depending upon the type and depth of the cauterization, it is effective for a few months to a few years, by which time the puncta can possibly regrow and reopen.
Any lasting sensitivity as a result of this cover can be reversed using short-term use of steroid eye drops such as those containing loteprednol.