Is tear duct cauterization wise?

If you did well with the plugs then more permanently closing the drainage system is a very good decision. There are fewer risks with cautery than with plugs. There is no worry about them falling out or migrating. The risk of infection is also eliminated. Hope this helps and good luck.

In permanent sever dry eye conditions, when the plugs are not staying in or causing foreign body sensation, punctual and canaliculi cauterization is a good and effective alternative.  It is not outdated and still the last resort for the sever dry eye conditions.  An Oculoplastic surgeon can evaluate and perform the right treatment.

If you have a definitive diagnosis of dry eyes, and you did not have overflow tearing while the punctal plugs were in place, then the answer is yes. Tear duct cauterization is not at all outdated and can make the difference between miserable dry eye symptoms and comfort. It is difficult to reverse if you decide your eyes are too wet or you have overflow tearing - so you want to be sure of your diagnosis. Your ophthalmologist or oculoplastic surgeon can confirm your diagnosis and give you advice. Best wishes.