J Korean Ophthalmol Soc.  2017 Apr;58(4):459-462. 10.3341/jkos.2017.58.4.459.

A Case of SmartPlug Partial Extrusion through Canalicular Mucosa

• Choi HS
• Lee SK
• Park JS
• Kim SJ

• KMID: 2376603
• DOI: http://doi.org/10.3341/jkos.2017.58.4.459

Abstract

PURPOSE
To report a case of a SmartPlug that partially extruded through the canalicular mucosa.
CASE SUMMARY
A 62-year-old female patient visited our Department of Ophthalmology for redness and discharge in her right eye that began worsening a week prior. The patient was diagnosed with severe dry eye syndrome via Sjogren's syndrome. The SmartPlug was inserted into her left lower punctum 12 years prior, and another plug was inserted in the right 9 years prior. Nothing notable was found in her history. The best corrected visual acuity and intraocular pressure at the initial visit was 1.0 and 14 mmHg, respectively, in both eyes. Swelling, erythema, and tenderness at the right lower punctum were identified. As we irrigated the lower lacrimal system, partial obstruction was suspected and a large amount of mucopurulent discharge in the conjunctival fornix with conjunctival injection was seen. Under the right lower punctum, a 1 × 1 mm yellowish foreign body was partially extruding from the canalicular mucosa. The foreign body was removed, and a round defect was left. The patient's symptom completely resolved after 4 weeks of topical antibiotics and ointment treatment.
CONCLUSIONS
In patients who have a SmartPlug inserted prior to visits for redness and discharge, a SmartPlug plug extrusion should be considered.

Keyword

Complication; Extrusion; Punctal plug; SmartPlug

MeSH Terms

Anti-Bacterial Agents
Dry Eye Syndromes
Erythema
Female
Foreign Bodies
Humans
Intraocular Pressure
Middle Aged
Mucous Membrane*
Ophthalmology
Sjogren's Syndrome
Visual Acuity
Anti-Bacterial Agents

Figure

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  Figure 1. Initial anterior segment photography. A 1 × 2 mm sized cylindrical yellowish foreign body (black arrow) parti-ally extruded under the right lower punctum.

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  Figure 2. After 4 weeks. (A) Round canalicular mucosa defect after foreign body removal and (B) completely resolving state after 4 weeks.

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  Figure 3. The foreign body. Removed foreign body was fully covered with discharge and blood clot. After dissection, It was found to be a 1 × 2 mm-sized SmartPlug.

Reference

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