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Purpose: Punctal occlusion using a silicone plug is an effective treatment for severe tear-deficient dry eye. At present, plugs from two companies are available in Japan [Eagle plug(EP); Eagle Vision, Punctal plug(PP); FCI]. We compared the extrusion rate between EP and PP in our dry eye clinic., Subjects and Methods: Subjects were 20 eyes of 18 patients for EP [5 eyes from 5 males, 15 eyes from 13 females, age: 58.1 +/- 17.5(mean +/- standard deviation)] and 76 eyes of 51 patients for PP (6 eyes from 5 males, 70 eyes from 46 females, age: 58.6 +/- 13.4), 62 eyes from 44 patients with Sjögren syndrome, 34 eyes from 25 patients with non-Sjögren syndrome with severe tear-deficient dry eye treated for the period of November 1996 to February 2002 in our dry eye clinic. We compared the extrusion rate for each plug and necessity of reinsertion of the plug., Results: In the examination for EP, 72.2% plugs were extruded during the follow-up periods, and the average period(59 days) until the extrusion was significantly shorter than for PP(p < 0.0001). In the examination for PP, 55.9% were extruded, and the average period until the extrusion was 287 days. Significant improvement of corneal epithelial damage was seen with PP after insertion of the plug. For the PP, reinsertion of plugs was sometimes impossible, probably because of the granulation formed inside the canaliculus, while for EP, reinsertion of the plugs was possible for all cases., Discussion: EP becomes extruded more easily than PP, and PP is seems for to form granulation more easily.

Purpose: Punctal occlusion using a silicone plug is one way of treating tear-deficient dry eye and it has been reported to be effective. We studied the outcome of punctal plug occlusion therapy for severe dry eye syndrome at our dry eye clinic., Subjects and Methods: Subjects were 76 eyes of 51 patients [6 eyes of 5 males, 70 eyes of 46 females, mean age: 58.6 +/- 13.4 (mean +/- standard deviation), 49 eyes of 30 patients with Sjögren's syndrome, 27 eyes of 21 patients without Sjögren's syndrome] with severe tear-deficient dry eye who underwent punctal occlusion using a silicone plug (Punctal plug, FCI Co. Ltd, France) during the period of Nov. 1996 to Mar. 2000 at our dry eye clinic. They were under observation for 632 +/- 405 days (mean +/- standard deviation). We studied if there is difference in tolerance between the sizes of punctal plug, compared epithelial damage before and after plug insertion, and studied relief in symptoms using self-assessment., Results: In tolerance of punctal plugs, 55.9% of all plugs were lost during our follow up, but there was no difference in time to loss between the sizes. Epithelial damage was reduced (p < 0.001). Dryness was the most reduced symptom: 26 patients (79%) got better, and only epiphora was increased, with 12 patients (36%) complaining slightly., Conclusion: Punctal plug occlusion therapy for tear-deficient dry eye is conclusively very effective.

We described the staining pattern of deposits in 4 cases of the staining method employing corneal dystrophy by avidin-biotin peroxidase complex employing biotinated lectins as intermediate products. The specimens consisted of 8 keratoplasty specimens obtained from 2 cases of granular dystrophy and 4 cases of lattice dystrophy and one case each of primary droplet dystrophy and Reis-Bücklers dystrophy. In two cases with granular dystrophy, deposits stained positively with WGA and with Con A in one case. The deposits found in lattice dystrophy were stained with WGA in 3 cases and with Con A in one case. The deposits noted in primary gelatinous droplet dystrophy were stained with WGA and those in Reis-Bücklers dystrophy were not stained with any lectin. The staining patterns suggested that the deposits found in granular and lattice dystrophy possess N-acetyl-D-glucosamine as a sugar residue. They may possess alpha-D-mannose and/or alpha-D-glucose.

Retrospective analysis of clinical cases observed for three years with respect to the appearance of the fundus and visual acuity was conducted to evaluate the effect of photocoagulation therapy on macular edema in relation to whither diabetic retinopathy was accompanied by, focal or cystoid, macular edema. In addition to glycemic control, focal and direct treatment of responsible lesions was found effective for focal macular edema in simple diabetic retinopathy. Concerning all types of retinopathy, the prognosis of focal macular edema was significantly favorable to that of cystoid macular edema. Blood sugar control also influenced the prognosis of focal edema. The changes of retinopathy were closely associated with the prognosis of focal macular edema in preproliferative and proliferative retinopathy. Disseminated photocoagulation and panretinal photocoagulation showed no difference as to the results of indirect treatment of focal macular edema in preproliferative retinopathy. Macular alterations other than macular edema occurred in a higher proportion of cases of proliferative retinopathy than in simple or preproliferative retinopathy. This accounted for low visual recovery in the former group in comparison to simple retinopathy. It was concluded that the direct treatment of the involved lesions is effective for focal macular edema in simple retinopathy and that extensive photocoagulation in preproliferative and proliferative retinopathy indirectly has a favorable influence on focal edema by means of amelioration of retinopathy.