Safety and Efficacy Study of RTP-008 (an Absorbable Tacrolimus Lacrimal Canalicular Plug) for Dry Eye

Brief Summary

RTP-008, an absorbable tacrolimus lacrimal canalicular plug, targets two key pathophysiological mechanisms of dry eye: tear retention and local anti-inflammation. This clinical trial aims to evaluate the safety and efficacy of RTP-008 in adults with moderate to severe dry eye. The main questions it aims to answer are: * Is RTP-008 safe for the eyes? * How well does the plug work to improve dry eye? * Which size provides a better fit for the human lacrimal canaliculus after swelling? Participants will be divided into three groups: * Two groups will receive RTP-008 inserted into their lacrimal canaliculus (in two slightly different sizes). * One comparison group will receive an already approved dissolvable plug. All participants will use a standard lubricating eye drop four times a day in both eyes. All participants will attend follow-up visits for 24 weeks so doctors can check their eye health and any side effects.