To compare the effects of treatment with
punctal plugs versus
artificial tears on visual function for primary Sjögren's syndrome with
dry eye. Forty-two eyes of 42 patients with primary Sjögren's syndrome were enrolled and were allocated randomly into
artificial tears (AT) group and
punctal plugs (PP) group. Ocular Surface Disease Index (OSDI) was used, and fluorescent staining for tear film break-up time (BUT), the Schirmer test I (
STI) and contrast sensitivity was performed before treatment and was repeated 3 months
after treatment. A follow-up of 3 months was achieved in 40 eyes of 40 patients, including 19 eyes in
artificial tears group and 21 eyes in
punctal plugs group. Statistically significant improvements were observed in the OSDI scores (AT: 52.6 ± 5.7, 15.9 ± 4.2; PP: 55.8 ± 4.9, 15.1 ± 4.2), corneal
fluorescein staining scores (AT: 2.60 ± 1.76, 0.30 ± 0.57; PP: 1.91 ± 1.60, 0.09 ± 0.29),
STI (AT: 3.85 ± 2.03, 8.95 ± 2.72; PP: 3.36 ± 1.62, 11.41 ± 2.65), and BUT (AT: 2.60 ± 1.39, 6.00 ± 1.81; PP: 2.27 ± 1.12, 7.82 ± 1.84)
after treatment compared to those of pre-treatment. The values of
STI (AT: 5.10 ± 1.80; PP: 8.05 ± 1.53) and BUT (AT: 3.40 ± 1.31; PP: 5.68 ± 1.13) in
punctal plugs group were significantly more improved than those in the
artificial tears group. The medium- and high-level frequencies contrast sensitivities were greatly improved in simulated daylight, night, and glare disability conditions
after treatment with
artificial tears and
punctal plugs. However, the changes in contrast sensitivity did not significantly differ between groups. Both
artificial tears and
punctal plugs relieved
dry eye symptoms, repaired corneal lesions, enhanced tear film stability, and improved contrast sensitivity.
Punctal plugs could improve tear film stability and elongate the BUT better than
artificial tears.