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Can you use Xiidra with punctal plugs?

Medically reviewed by Sally Chao, MD. Last updated on Aug 24, 2023.

Official answer


Yes, you can use Xiidra (lifitegrast ophthalmic) with punctal plugs.

In one study in Clinical Ophthalmology looking at the safety and benefits of Xiidra as a treatment for dry eye, 39 of the 168 trial participants also had punctal plugs. In a clinical trial of Xiidra posted on, patients were allowed to enroll and undergo treatment with Xiidra even if they had punctal plugs inserted.

Punctal plugs block tears from draining out of the eyes, maintaining moisture on your eye’s surface, while Xiidra fights inflammation and increases tear production. Xiidra is a prescription solution delivered twice daily to the eyes, and punctal plugs are inserted by an ophthalmologist during an in-office procedure.

The decision to use Xiidra and punctal plugs together will depend on:

  • The severity of your dry eye symptoms
  • How well treatments are managing your symptoms
  • Other options used in the past

For example, your doctor may suggest using Xiidra and punctal plugs together if one option alone does not adequately control symptoms.

For some, punctal plugs or Xiidra alone may be enough to control dry eye symptoms. For example, research suggests that punctal plugs can often eliminate or significantly reduce the need to use artificial tears or other dry eye medications.

  1. Atallah RT, Castanos MV, Najac R, Donnenfeld E. Six months' treatment with lifitegrast in patients with moderate-to-severe symptomatic dry eye: a retrospective chart review. Clin Ophthalmol. 2019;13:1033-1037. doi: 10.2147/OPTH.S191635.
  2. Clinical Efficacy of Two Topical Dry Eye Drops for Central Corneal Stain Clearing Over 90 Days. Last updated October 9, 2020. Available at: [Accessed August 25, 2021].
  3. American Academy of Ophthalmology (AAO). Punctal Plugs. Available at: [Accessed August 25, 2021].
  4. American Association of Retired Persons (AARP). How to Treat Dry Eyes. Last reviewed July 22, 2021. Available at: [Accessed August 25, 2021].
  5. American Academy of Ophthalmology (AAO). Will I need to continue drops for dry eye if I get plugs? January 17, 2019. Available at: [Accessed August 25, 2021].
  6. American Academy of Ophthalmology (AAO). Considerations for Lacrimal Occlusion in the Moderate Dry Eye Patient. Available at: [Accessed August 25, 2021].
  7. Song JS, Woo IH, Eom Y, Kim HM. Five Misconceptions Related to Punctal Plugs in Dry Eye Management. Cornea. 2018;37 Suppl 1:S58-S61. doi: 10.1097/ICO.0000000000001734.

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