Punctal occlusion surgery
This may be an option for patients whose symptoms of dry eye cannot be adequately controlled with conservative measures. The goal of this surgery is to occlude (block) the tear ducts that drain tears from the eye. Temporary punctal occlusion involves surgically inserting collagen (or an alternative polymer) or silicone plugs into the tear ducts. The former plugs are absorbable and last for variable periods of time (3 days to 6 months). The latter are non-absorbable "permanent" plugs. Permanent punctal occlusion may also involve using a laser or electrocautery device to permanently seal-shut the tear ducts. This enables the tears to pool, thus delivering moisture to the eyes.
Salivary gland autotransplantation
This procedure is normally only recommended after all other treatment options have been tried. The glands that produce saliva are removed from the lower lip and grafted into the side of the eyes. The saliva produced by the glands acts as a tear substitute.