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Can lacrimal punctum size link to the severity of dry eye disease?
Author(s) -
Ming Chen,
JerrisR Hedges,
SoYung Choi,
Keke Liu,
Szu-Yuan Lin
Publication year - 2022
Publication title -
taiwan journal of ophthalmology
Language(s) - English
Resource type - Journals
eISSN - 2211-5072
pISSN - 2211-5056
DOI - 10.4103/tjo.tjo_15_21
Subject(s) - medicine , ophthalmology , spearman's rank correlation coefficient , meibomian gland , rank correlation , surgery , eyelid , statistics , mathematics , machine learning , computer science
To investigate if larger punctum size links to the severity of dry eye disease (DED) and perhaps, punctum size inspection can be adopted to become one of the DED evaluations for practitioners. The records of 200 eyes of 114 patients that had temporary collagen punctum plugs due to severe DED (Level 2 to Level 4) from January 1, 2017, to July 31, 2018, were reviewed for the size of the plugs. Lacrimal punctum size of those eyes was approximated according to the size of vertical canalicular soft collagen plug (from 0.3 to 0.5 mm diameter, Oasis, Lacrimedics, Glendora, CA, USA). The dry eye severity grading from the International Dry Eye WorkShop was used to grade the level of the severity of DED. Those eyes classified as Level 2 and above were considered as severe due to the presentation of moderate-to-diffuse corneal staining and symptomatic. To assess if there is a correlation between punctum size and the severity of DED, the Spearman's rank correlation coefficient was calculated. Of the 200 Level 2 and above eyes, 131 (66%) eyes had a large punctum (≥0.5 mm). Punctum size larger than 0.4 mm was 95%. The estimated Spearman's ρ was 0.16. This indicates a statistical significant positive correlation ( P = 0.02) between larger punctum size and higher level of DED. The larger size of lacrimal punctum may link to the severity of DED. Punctum inspection may be adopted to become one parameter for DED evaluation for practitioners.

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