Name of the Procedure:

Insertion of drug-eluting implant into lacrimal canaliculus (including punctal dilation and implant removal when performed)

Summary

This procedure involves placing a small, drug-releasing implant into the lacrimal canaliculus (the small channels that drain tears from the eye). It may include dilating the puncta (tear ducts) and removing any previous implants if necessary.

Purpose

The primary purpose is to deliver medication directly to the eye over an extended period. It is often used to treat chronic dry eye and certain inflammatory eye conditions.

Indications

• Chronic dry eye unresponsive to other treatments
• Inflammatory eye conditions requiring long-term medication
• Previous ocular surgeries where standard treatments are ineffective

Preparation

• Patients should follow specific instructions provided by their doctor, which may include avoiding certain medications and fasting.
• A thorough eye examination will be conducted to assess suitability.
• Pre-procedure diagnostic tests may include tear production measurement and ocular surface evaluation.

Procedure Description

1. The patient is comfortably seated, and a local anesthetic is administered to numb the eye.
2. The punctum, the opening of the tear duct, is gently dilated using specialized instruments.
3. The drug-eluting implant is carefully inserted into the lacrimal canaliculus.
4. If a previous implant is already in place, it will be removed before the new insertion.
5. The procedure is usually painless due to the local anesthesia.

Duration

The procedure typically takes about 15-30 minutes.

Setting

The procedure is performed in an outpatient clinic or eye care center.

Personnel

• Ophthalmologist or eye care specialist
• Nursing staff for preparation and assistance
• Optional: Anesthesiologist or nurse anesthetist if deeper sedation is required

Risks and Complications

• Mild discomfort or irritation at the insertion site
• Risk of infection, which can be managed with antibiotics
• Possible displacement or dislodgement of the implant
• Rarely, allergic reaction to the implant materials

Benefits

• Continuous delivery of medication directly to the eye
• Reduced need for frequent eye drops
• Improvement in symptoms of dry eye and inflammation typically within a few days to weeks

Recovery

• Patients can usually resume normal activities immediately after the procedure.
• Follow-up appointments to monitor the implant and eye condition.
• Instructions may include the use of antibiotic eye drops to prevent infection.

Alternatives

• Regular eye drops or ointments
• Oral medications
• Punctal plugs (non-drug eluting)
• In severe cases, surgical interventions

Patient Experience

• The procedure is generally well-tolerated with minimal discomfort.
• Some patients may feel a slight pressure during the insertion.
• Post-procedure, there may be mild irritation, which is typically managed with over-the-counter pain relief.