A Case of Chronic Granulomatous Canaliculitis Induced by Herrick Silicone Punctual Plug

ABSTRACT

PURPOSE: To report the experience of treating chronic granulomatous canaliculitis induced by permanent silicone punctal plugs used for dry eye syndrome treatment. METHODS: The transformation of puncta below both eyes and secretions in the lacrimal duct were observed for a 56-year-old female patient who had attended hospital for 4 months due to epiphora and secretions. Under the diagnosis of lacrimal duct inflammation for the lower lacrimal duct of both eyes, three-snip punctoplasty, curettage in the lacrimal duct, and pathological examination on the part of the lacrimal duct obtained from the three-snip punctoplasty were carried out. RESULTS: The lacrimal silicone plugs were removed from the lacrimal duct at the time of the lacrimal duct curettage, and a diagnosis was made based on tissue biopsy of chronic granulomatous canaliculitis induced by permanent silicone punctal plugs. After the above surgical operations, the epiphora and the anterior eye segment symptom both disappeared. CONCLUSIONS: The permanent silicone punctal plug used to permanently close the lacrimal punctum scarcely causes disorder in the lacrimal drainage system with epiphora and inflammation by acting as a foreign substance. It therefore should only be used when essential.