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DEDNCT07571330

Upper Punctal Plug Occlusion in Previous Lower Punctal Occlusion.

A study testing Punctal plug occlusion in people with DED and Aqueous-deficient Dry Eye Disease, run by Universidad Autonoma de Nuevo Leon at 1 site in Mexico.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This study evaluates the therapeutic effect of upper punctal plug occlusion in patients with dry eye disease with previous lower punctal occlusion. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
DED, Aqueous-deficient Dry Eye Disease
What is being tested?
Punctal plug occlusion
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
36 participants
Where
1 siteMexico
Study dates
12 Feb 2026to 1 Nov 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients of both sexes
  • One or both eyes may be included
  • Inferior lacrimal punctum occluded (with a punctal plug or cauterization), clinically sealed under slit-lamp examination
  • Functional superior lacrimal punctum
  • Aqueous-deficient dry eye (such as Sjögren's disease, graft-versus-host disease, or primary dry eye disease.)
  • Age >18 years
  • OSDI score >13 and one of the following signs: Tear film markers (Fluorescein tear break up-time <5, First non-invasive tear breakup time <10, Schirmer test without anesthesia <10 mm, Schirmer test with anesthesia <10 mm), Ocular surface markers (corneal staining >5 spots or conjunctival staining >9 spots).

Who cannot join

  • Active ocular surface infection.
  • Patients who are unwilling to participate or to provide written informed consent.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Karim Mohamed-Noriega, Dr. med. contact

+52 8113404960 ext. 8514

karim.mohamednr@uanl.edu.mx

Mexico1 site, 1 recruiting
  • Ophthalmology Department

    Monterrey, Nuevo León, 64460

    Karim Mohamed-Noriega, Dr. med., +52 8113404960 ext. 8514, karim.mohamednrg@uanl.edu.mx

    Recruiting

Other trials in Mexico

About this study

Official title: Effectiveness of Upper Punctal Plug Occlusion in Patients With Dry Eye Disease With Previous Lower Punctal Occlusion.

This study evaluates the therapeutic effect of upper punctal plug occlusion in patients with dry eye disease with previous lower punctal occlusion.

Read the detailed description

This prospective, consecutive, interventional, longitudinal, case series study includes patients with aqueous-deficient dry eye disease who have inferior punctal occlusion. The study aims to evaluate the effect of superior lacrimal punctal occlusion with a plug dry eye symptoms and signs. Assessments will be performed at baseline and at 2 weeks, 4 weeks, 3 months, and 6 months following superior punctal occlusion

Being tested
Punctal plug occlusion
Keywords
Aqueous-deficient dry eye disease, DED, Punctual plug, Superior punctual plug

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Punctal plug occlusionProcedure or surgery

    Superior lacrimal punctal occlusion with plug in patients with aqueous-deficient dry eye who have previously occlusion of the inferior lacrimal punctum.

Study groups in NCT07571330
Study groupRoleWhat they receive
1 arm, superior lacrimal punctal occlusion with plug in patients with aqueous-deficient dry eye whoExperimental1 arm, superior lacrimal punctal occlusion with plug in patients with aqueous-deficient dry eye who have previously occlusion of the inferior lacrimal punctum.
Receives: Procedure: Punctal plug occlusion

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. 1. Effectiveness

    To evaluate signs and symptoms of dry eye, after superior lacrimal punctal occlusion with plug in patients with aqueous-deficient dry eye who have previously occlusion of the inferior lacrimal punctum at baseline, 2 weeks, 4 weeks, 3 months and 6 months

    Measured: Baseline, 2 weeks, 4 weeks, 3 months and 6 months

Secondary outcomes (12)
  1. Change in lower tear meniscus heigh

    Change in lower tear meniscus height measured using Keratograph and optical coherence tomography (OCT) after upper punctal plug placement.

    Measured: Baseline to 3 months after upper punctal plug placement.

  2. Change in lower tear meniscus area

    Change in lower tear meniscus area measured using Keratograph and optical coherence tomography (OCT) after upper punctal plug placement.

    Measured: Baseline to 3 months after upper punctal plug placement.

  3. Change from baseline in dry eye severity as assessed by the Ocular Surface Disease Index (OSDI)

    The OSDI is a validated 12-item questionnaire evaluating dry eye symptoms and their impact on vision-related functioning across three domains: ocular symptoms, visual function, and environmental triggers. Each item is scored on a 5-point scale (0 = none of the time to 4 = all of the time). The total OSDI score is calculated as:

    OSDI= number of questions answered (sum of scores)×25

    Scores range from 0 to 100, with higher scores indicating greater disability. Severity categories are: normal (0-12), mild (13-22), moderate (23-32), and severe (33-100).

    Measured: Baseline to 3 months after upper punctal plug placement.

  4. Change from baseline in dry eye symptoms as assessed by the Symptom Assessment in Dry Eye (SANDE) scale.

    The SANDE is a validated, patient-reported outcome measuring dry eye symptom burden using two 100-mm visual analog scales assessing frequency and severity of symptoms (0 = none, 100 = maximal). The composite SANDE score is calculated as the square root of the product of frequency and severity scores:

    Higher scores indicate worse symptoms.

    Measured: Baseline to 3 months after upper punctal plug placement.

  5. Change in tear film break-up time (TFBUT).

    Change in tear film break-up time measured with fluorescein after upper punctal plug placement.

    Measured: Baseline to 3 months after upper punctal plug placement.

  6. Change in non-invasive tear break-up time (NIBUT).

    Change in non-invasive tear break-up time measured using Keratograph after upper punctal plug placement.

    Measured: Baseline to 3 months after upper punctal plug placement.

  7. Change from baseline in ocular surface damage as assessed by the SICCA Ocular Surface Staining Score (OSS).

    The SICCA OSS is a standardized clinical grading system developed by the Sjögren's International Collaborative Clinical Alliance to quantify ocular surface epithelial damage using vital dyes. The score combines fluorescein corneal staining and lissamine green conjunctival staining in each eye.

    Measured: Baseline to 3 months after upper punctal plug placement.

  8. Change from baseline in corneal epithelial damage as assessed by the National Eye Institute Corneal Fluorescein Staining (NEI) score

    The NEI corneal fluorescein staining score is a standardized slit-lamp-based grading system used to quantify corneal epithelial damage after fluorescein instillation. The cornea is divided into five regions (central, superior, inferior, nasal, and temporal). Each region is graded on a 0 to 3 scale based on staining density and extent:

    0 = no staining

    1. = sparse punctate staining
    2. = moderate/dense punctate staining
    3. = severe staining or coalescent areas

    The total NEI score is the sum of all regions, ranging from 0 to 15, with higher scores indicating greater corneal epithelial damage.

    Measured: Baseline to 3 months after upper punctal plug placement.

  9. Change in Schirmer I test results.

    Change in tear production measured using the Schirmer I test with and without anesthesia after upper punctal plug placement.

    Measured: Baseline to 3 months after upper punctal plug placement.

  10. Change in corneal sensitivity.

    Change in corneal sensitivity measured by corneal esthesiometry after upper punctal plug placement.

    Measured: Baseline to 3 months after upper punctal plug placement.

  11. Incidence of epiphora after upper punctal plug placement.

    Incidence of epiphora reported after upper punctal plug placement during the follow-up period.

    Measured: Up to 3 months after upper punctal plug placement.

  12. Upper punctal plug retention rate.

    Proportion of upper punctal plugs remaining in place during the follow-up period after placement.

    Measured: Up to 3 months after upper punctal plug placement.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 May 2026
  2. Study start12 Feb 2026
  3. Primary completion1 Oct 2026
  4. Study completion1 Nov 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Other
Allocation
Not applicable
Intervention model
Single group
Model description
Prospective, consecutive, interventional case series study of patients with aqueous-deficient dry eye disease.
Masking
None (open label)
Enrolment
36 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07571330
Sponsor's protocol ID
OF25-00001
Status last verified
Feb 2026
First submitted
12 Feb 2026
Last updated
16 Oct 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Qiu W, Liu Z, Ao M, Li X, Wang W. Punctal plugs versus artificial tears for treating primary Sjogren's syndrome with keratoconjunctivitis SICCA: a comparative observation of their effects on visual function. Rheumatol Int. 2013 Oct;33(10):2543-8. doi: 10.1007/s00296-013-2769-1. Epub 2013 May 7.

    PubMed 23649850
  • Perez VL, Chen W, Craig JP, Dogru M, Jones L, Stapleton F, Wolffsohn JS, Sullivan DA. TFOS DEWS III: Executive Summary. Am J Ophthalmol. 2026 Feb;282:135-145. doi: 10.1016/j.ajo.2025.09.035. Epub 2025 Sep 24.

    PubMed 41005521
  • Marcet MM, Shtein RM, Bradley EA, Deng SX, Meyer DR, Bilyk JR, Yen MT, Lee WB, Mawn LA. Safety and Efficacy of Lacrimal Drainage System Plugs for Dry Eye Syndrome: A Report by the American Academy of Ophthalmology. Ophthalmology. 2015 Aug;122(8):1681-7. doi: 10.1016/j.ophtha.2015.04.034. Epub 2015 May 30.

    PubMed 26038339
  • Lanza NL, Valenzuela F, Perez VL, Galor A. The Matrix Metalloproteinase 9 Point-of-Care Test in Dry Eye. Ocul Surf. 2016 Apr;14(2):189-95. doi: 10.1016/j.jtos.2015.10.004. Epub 2016 Feb 2.

    PubMed 26850527
  • Kaido M, Ishida R, Dogru M, Tsubota K. Comparison of retention rates and complications of 2 different types of silicon lacrimal punctal plugs in the treatment of dry eye disease. Am J Ophthalmol. 2013 Apr;155(4):648-653, 653.e1. doi: 10.1016/j.ajo.2012.10.024. Epub 2013 Jan 11.

    PubMed 23317650
  • Hallali G, Guindolet D, Gabison EE, Cochereau I, Doan S. Immediate and Delayed Effects of Punctal Plug Insertion on Tear Meniscus Height in Severe Aqueous-Deficient Dry Eye. Cornea. 2024 Jul 1;43(7):890-894. doi: 10.1097/ICO.0000000000003477. Epub 2024 Jan 30.

    PubMed 38289716
  • Craig JP, Nichols KK, Akpek EK, Caffery B, Dua HS, Joo CK, Liu Z, Nelson JD, Nichols JJ, Tsubota K, Stapleton F. TFOS DEWS II Definition and Classification Report. Ocul Surf. 2017 Jul;15(3):276-283. doi: 10.1016/j.jtos.2017.05.008. Epub 2017 Jul 20.

    PubMed 28736335
  • Chen F, Wang J, Chen W, Shen M, Xu S, Lu F. Upper punctal occlusion versus lower punctal occlusion in dry eye. Invest Ophthalmol Vis Sci. 2010 Nov;51(11):5571-7. doi: 10.1167/iovs.09-5097. Epub 2010 May 12.

    PubMed 20463310
  • Chen F, Shen M, Chen W, Wang J, Li M, Yuan Y, Lu F. Tear meniscus volume in dry eye after punctal occlusion. Invest Ophthalmol Vis Sci. 2010 Apr;51(4):1965-9. doi: 10.1167/iovs.09-4349. Epub 2009 Nov 20.

    PubMed 19933200
  • Burgess PI, Koay P, Clark P. SmartPlug versus silicone punctal plug therapy for dry eye: a prospective randomized trial. Cornea. 2008 May;27(4):391-4. doi: 10.1097/ICO.0b013e318160d030.

    PubMed 18434839
  • Boldin I, Klein A, Haller-Schober EM, Horwath-Winter J. Long-term follow-up of punctal and proximal canalicular stenoses after silicone punctal plug treatment in dry eye patients. Am J Ophthalmol. 2008 Dec;146(6):968-72.e1. doi: 10.1016/j.ajo.2008.06.028. Epub 2008 Aug 23.

    PubMed 18723140
  • Balaram M, Schaumberg DA, Dana MR. Efficacy and tolerability outcomes after punctal occlusion with silicone plugs in dry eye syndrome. Am J Ophthalmol. 2001 Jan;131(1):30-6. doi: 10.1016/s0002-9394(00)00620-6.

    PubMed 11162976
  • Ali MJ, Singh S. Optical coherence tomography and the proximal lacrimal drainage system: a major review. Graefes Arch Clin Exp Ophthalmol. 2021 Nov;259(11):3197-3208. doi: 10.1007/s00417-021-05175-3. Epub 2021 Apr 16.

    PubMed 33861367
  • Ahn H, Ji YW, Jun I, Kim TI, Lee HK, Seo KY. Comparison of Treatment Modalities for Dry Eye in Primary Sjogren's Syndrome. J Clin Med. 2022 Jan 17;11(2):463. doi: 10.3390/jcm11020463.

    PubMed 35054155

Questions about this trial

What is this clinical trial studying?

A study testing Punctal plug occlusion in people with DED and Aqueous-deficient Dry Eye Disease, run by Universidad Autonoma de Nuevo Leon at 1 site in Mexico.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 16 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Mexico. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Karim Mohamed-Noriega, Dr. med. (+52 8113404960 ext. 8514, karim.mohamednr@uanl.edu.mx), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

1. Effectiveness (time frame: Baseline, 2 weeks, 4 weeks, 3 months and 6 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07571330, which also lists 14 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Oct 2026.

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