Cochrane · systematic review · CD006775
Punctal occlusion for dry eye syndrome
Ervin, AM, Law, A, Pucker, AD · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
Eyes and VisionAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
48
current version
GRADE rated
35
No studies
11
Included studies
NR
No studies 11 · 22.9%Ungraded 2 · 4.2%Very low 26 · 54.2%Low 8 · 16.7%Moderate 1 · 2.1%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Summary of findings: punctal plugs versus no punctal plugs
Population: adults with dry eye syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Symptomatic improvement Summary of findings: punctal plugs vs no punctal plugs | no estimate extracted | 2 studies · 89 participants | Very low Downgraded: risk of bias, inconsistency |
Ocular surface staining Summary of findings: punctal plugs vs no punctal plugs | no estimate extracted | 1 study · 61 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Aqueous tear production Summary of findings: punctal plugs vs no punctal plugs | no estimate extracted | 1 study · 28 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Tear film stability Summary of findings: punctal plugs vs no punctal plugs | no estimate extracted | 1 study · 28 participants | Low Downgraded: risk of bias, inconsistency |
Artificial tear use Summary of findings: punctal plugs vs no punctal plugs | no estimate extracted | 1 study · 61 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Adverse events Summary of findings: punctal plugs vs no punctal plugs | no estimate extracted | 4 studies · 146 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Summary of findings: punctal plugs versus cyclosporine
Population: adults with dry eye syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Symptomatic improvement Summary of findings: punctal plugs vs cyclosporine | no estimate extracted | 2 participants | Ungraded |
Ocular surface staining Summary of findings: punctal plugs vs cyclosporine | no estimate extracted | 1 study · 20 participants | Very low Downgraded: imprecision |
Aqueous tear production Summary of findings: punctal plugs vs cyclosporine | no estimate extracted | 1 study · 20 participants | Very low Downgraded: imprecision |
Tear film stability Summary of findings: punctal plugs vs cyclosporine | no estimate extracted | 2 participants | Ungraded |
Artificial tear use Summary of findings: punctal plugs vs cyclosporine | no estimate extracted | 1 study · 20 participants | Very low Downgraded: imprecision |
Adverse events Summary of findings: punctal plugs vs cyclosporine | no estimate extracted | 1 study · 22 participants | Very low Downgraded: imprecision |
Summary of findings: punctal plugs versus oral pilocarpine
Population: adults with dry eye syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Symptomatic improvement Summary of findings: punctal plugs vs oral pilocarpine | RR 0.69 [0.49, 0.95] | NR | Very low Downgraded: risk of bias, imprecision |
Ocular surface staining Summary of findings: punctal plugs vs oral pilocarpine | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Aqueous tear production Summary of findings: punctal plugs vs oral pilocarpine | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Tear film stability Summary of findings: punctal plugs vs oral pilocarpine | no estimate extracted | NR | No studies |
Artificial tear use Summary of findings: punctal plugs vs oral pilocarpine | no estimate extracted | NR | No studies |
Adverse events Summary of findings: punctal plugs vs oral pilocarpine | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Summary of findings: punctal plugs versus artificial tears
Population: adults with dry eye syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Symptomatic improvement Summary of findings: punctal plugs vs artificial tears | RR 2.29 [1.2, 4.38] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency |
Ocular surface staining Summary of findings: punctal plugs vs artificial tears | no estimate extracted | NR | Low Downgraded: imprecision |
Aqueous tear production Summary of findings: punctal plugs vs artificial tears | no estimate extracted | NR | Low Downgraded: imprecision, inconsistency |
Tear film stability Summary of findings: punctal plugs vs artificial tears | no estimate extracted | NR | Moderate Downgraded: imprecision |
Artificial tear use Summary of findings: punctal plugs vs artificial tears | no estimate extracted | NR | No studies |
Adverse events (punctate epithelial keratopathy) Summary of findings: punctal plugs vs artificial tears | RR 1.33 [0.57, 3.12] | NR | Low Downgraded: risk of bias, imprecision |
Summary of findings: punctal plugs in the upper versus lower puncta
Population: adults with dry eye syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Symptomatic improvement Summary of findings: punctal plugs in the upper vs lower puncta | no estimate extracted | NR | No studies |
Ocular surface staining Summary of findings: punctal plugs in the upper vs lower puncta | no estimate extracted | NR | No studies |
Aqueous tear production Summary of findings: punctal plugs in the upper vs lower puncta | no estimate extracted | NR | No studies |
Tear film stability Summary of findings: punctal plugs in the upper vs lower puncta | no estimate extracted | NR | No studies |
Artificial tear use Summary of findings: punctal plugs in the upper vs lower puncta | no estimate extracted | NR | No studies |
Adverse events Summary of findings: punctal plugs in the upper vs lower puncta | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Summary of findings: acrylic versus silicone punctal plugs
Population: mostly women with dry eye syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Symptomatic improvement Summary of findings: acrylic vs silicone punctal plugs | no estimate extracted | NR | Very low Downgraded: imprecision |
Ocular surface staining Summary of findings: acrylic vs silicone punctal plugs | no estimate extracted | NR | Very low Downgraded: imprecision |
Aqueous tear production Summary of findings: acrylic vs silicone punctal plugs | no estimate extracted | NR | Very low Downgraded: imprecision |
Tear film stability Summary of findings: acrylic vs silicone punctal plugs | no estimate extracted | NR | Very low Downgraded: imprecision |
Artificial tear use Summary of findings: acrylic vs silicone punctal plugs | no estimate extracted | NR | Very low Downgraded: imprecision |
Adverse events Summary of findings: acrylic vs silicone punctal plugs | no estimate extracted | NR | Very low Downgraded: imprecision |
Summary of findings: intracanalicular versus silicone punctal plugs
Population: adults with dry eye syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Symptomatic improvement Summary of findings: intracanalicular vs silicone punctal plugs | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Ocular surface staining Summary of findings: intracanalicular vs silicone punctal plugs | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Aqueous tear production Summary of findings: intracanalicular vs silicone punctal plugs | no estimate extracted | NR | No studies |
Tear film stability Summary of findings: intracanalicular vs silicone punctal plugs | no estimate extracted | NR | No studies |
Artificial tear use Summary of findings: intracanalicular vs silicone punctal plugs | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Adverse events Summary of findings: intracanalicular vs silicone punctal plugs | no estimate extracted | NR | No studies |
Summary of findings: collagen versus silicone punctal plugs
Population: adults with dry eye syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Symptomatic improvement Summary of findings: collagen vs silicone punctal plugs | no estimate extracted | NR | Very low Downgraded: imprecision |
Ocular surface staining Summary of findings: collagen vs silicone punctal plugs | no estimate extracted | NR | Very low Downgraded: imprecision |
Aqueous tear production Summary of findings: collagen vs silicone punctal plugs | no estimate extracted | NR | Very low Downgraded: imprecision |
Tear film stability Summary of findings: collagen vs silicone punctal plugs | no estimate extracted | NR | Very low Downgraded: imprecision |
Artificial tear use Summary of findings: collagen vs silicone punctal plugs | no estimate extracted | NR | Low Downgraded: imprecision |
Adverse events Summary of findings: collagen vs silicone punctal plugs | no estimate extracted | NR | Very low Downgraded: imprecision |