J Korean Ophthalmol Soc.  2014 May;55(5):746-749. 10.3341/jkos.2014.55.5.746.

A Case of Acquired Lacrimal Fistula Caused by Silicone Tube Remnant

• Song YJ
• Jeong JS
• Yang SW

• KMID: 2218097
• DOI: http://doi.org/10.3341/jkos.2014.55.5.746

Abstract

PURPOSE
To report a case of acquired lacrimal fistula caused by silicone tube remnant.
CASE SUMMARY
A 56-years-old female who suffered from purulent discharge in inner skin of the right lower eyelid visited our clinic. Lacrimal fistula was found in the skin at the medial side of the right lower eyelid. The patient reported that she had a silicone tube intubation operation 3 years prior due to a nasolacrimal obstruction of right eye. On syringing test, saline solution and purulent discharge were drained from the fistula skin opening and there was no nasolacrimal obstruction. After admission, antibiotic treatment and potadine soaking dressing were performed to facilitate spontaneous closing of the lacrimal fistula. However, the lacrimal fistula relapsed and lacrimal fistulectomy and bicanalicular silicone tube intubation were performed. During surgery, silicone tube remnant material not totally extubated at the lacrimal sac was found which we removed. Postoperatively, systemic antibiotic therapy was administered and the chronic inflammation improved.
CONCLUSIONS
We report a case of lacrimal fistula caused by silicone tube remnant in the lacrimal sac. Acquired lacrimal fistula caused by a silicone tube remnant can be treated by fistulectomy and silicone tube remnant removal.

Keyword

Acquired lacrimal fistula; Silicone tube remnant

MeSH Terms

Bandages
Eyelids
Female
Fistula*
Humans
Inflammation
Intubation
Silicones*
Skin
Sodium Chloride
Silicones
Sodium Chloride

Figure

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  Figure 1. Acute purulent dacryocystitis was treated with incision followed by drainage: there was a noticeable improvement following the incision site being sutured. However, the lacrimal fistula still persisted.

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  Figure 2. A remnant of silicone tube found at the lacrimal sac.

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  Figure 3. Histiology slide of tissue from the lacrimal duct area: In low power field, areas of aggregated lymphoid cells (arrow) and fibrosis (black star) are noted, implying that there is chronic inflammation with fibrosis.

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  Figure 4. Following the fistulectomy and bicanalicular silicone tube intubation: no further sign of inflammation or fistula observed.

Reference

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