Dry eye occurs when the eye does not produce enough tears or the tears don't work properly to keep the eye lubricated, says the National Eye Institute. This can lead to serious problems including pain, ulcers, scarring and even vision loss. However, this rarely happens because dry eye is treatable, usually with artificial tears or drugs. When those don't work, there are surgical procedures that can help with dry eye.
Plugs
Tiny silicone plugs are surgically inserted into the drainage holes in the corners of the eye where tears normally drain into the nose, says the National Eye Institute. These are called lacrimal or punctal plugs and are usually used for temporary relief, although they can be inserted permanently. The plugs work by keeping both natural and artificial tears on the eye longer to maintain moisture. The plugs are inserted in the doctor's office with a special instrument under a local anesthetic. Once they're in, they usually can't be felt. Side effects include inflammation, infection, and the chance that the plug will migrate into the tear duct and may need to be surgically removed.
Punctal Cautery
A permanent alternative is to surgically close the tear drainage holes in a procedure called punctal cautery, notes the National Eye Institute. After numbing the eye, the doctor uses a heated wire to cauterize the drainage holes, which causes scarring that permanently closes the holes. This works the same way punctal plugs do--it keeps what tears are being produced on the eyes to keep them moist. The procedure can cause some scarring in the area and damage to the eyelid, warns Optometric Management. Also, the drainage holes can sometimes reopen over time.
Punctal Ablation
In punctal ablation an argon laser is used to seal the drainage holes permanently, just as in punctal cautery. The doctor gives the patient a local anesthetic and then the laser is applied for only a few seconds to close the drainage holes. The advantage over a standard punctal cautery is that the holes do not reopen over time. The risk is that if the laser is applied too long, scarring can occur.
