LACRIFILL Canalicular Gel

LACRIFILL canalicular gel is a soft, cross-linked hyaluronic acid (HA) gel that an eye doctor places inside the tear duct (canaliculus) to slow tear drainage. By keeping more of your own tears on the eye, it can ease burning, stinging, fluctuating vision, and gritty feelings caused by dry eye disease. Dry eye is common and affects everyday tasks like reading and screen time. 1

LACRIFILL works like a temporary, dissolvable plug inside the drainage channel, much like punctal plugs—which are proven options to help keep the eye surface moist. 2

Because HA is a substance already found in the eye and body, the gel is designed to be comfortable and biocompatible. It gradually breaks down over months, so the effect is temporary and adjustable. This can be helpful if you want tear conservation without a permanent implant or surgery. Your ophthalmologist can also flush the gel if needed, offering an added layer of safety and control. 3

Early clinical studies of HA canalicular gel show improvements in common dry eye measures such as Schirmer testing and corneal staining. 4

What happens on procedure day?

• After numbing drops, your doctor gently dilates the punctum (the tiny opening on the lid margin) and confirms that the drainage pathway is open.
• Using a fine cannula, a small amount of LACRIFILL is placed into the canaliculus to create a soft, internal blockage.
• Most people feel only mild pressure and can go home the same day.

A pilot clinical study of intracanalicular cross-linked HA gel reported meaningful gains in tear metrics and surface health over 1–3 months. 4

How long does it last?

The gel is designed to last several months and then slowly dissolve, similar to other temporary occlusion methods. If symptoms return, the gel can be replaced during a brief office visit. 12

You may be a good candidate if you have moderate to severe dry eye symptoms despite using artificial tears or prescription drops. Aqueous-deficient dry eye (not making enough tears) is especially likely to benefit from slowing tear drainage. 5

• Candidates usually have open tear drainage pathways (no active blockage or infection) and a healthy eyelid margin.
• LACRIFILL can be considered if you want a reversible, in-office option and either disliked surface plugs in the past or had issues like plug loss or irritation. 2
• People with mainly evaporative dry eye from meibomian gland dysfunction (MGD) may still benefit, but often need lid therapies in addition.

The cost of LACRIFILL varies by clinic, region, and insurance. Because it is a procedure done in the office, pricing may include:

• The exam
• The device
• The doctor’s time

Coverage differs widely and may depend on medical necessity. Many doctors try drops, lifestyle changes, and warm compresses first before moving to procedures like tear duct occlusion. 8

Benefits

• Uses your own tears to bathe the surface, easing burning, stinging, and blurred vision.
• Temporary and reversible—gel can be flushed if needed.
• Data suggest improvement in dry eye measures and symptoms for several months. 9
• HA is biocompatible and widely used in eye care. 4

Limitations & Risks

• Not a cure; many patients still need lid care and drops.
• Side effects are usually mild (watering, irritation) but can rarely include inflammation or infection. 6
• People with severe evaporative disease often need added MGD treatment.

Most people resume normal activity right after the visit. Your doctor may suggest:

• Preservative-free artificial tears
• Warm compresses
• Gentle lid hygiene

If the gel feels too strong (watering) or too weak (symptoms return), dosing can be adjusted at later visits, or the gel can be flushed—offering flexibility as your needs change. 2

A multicenter, randomized, double-masked clinical trial compared cross-linked HA canalicular gel (LACRIFILL) with a hydrogel plug and found the gel was non-inferior for improving tear production, with benefits through six months. 9

Expert summaries highlight its reversibility and potential to avoid plug issues like extrusion. 10

If dry eye is holding you back, consider a visit with a Cornea & External Disease ophthalmologist to see whether LACRIFILL canalicular gel fits your plan. Bring:

• A list of symptoms
• What you have tried
• Your daily screen time and environment

Kerbside can help you connect with the right specialist for a medical education consult so you can ask questions and understand options. This is not a physician-patient relationship or treatment plan, but it can prepare you for an in-person exam.