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Complications of intracanalicular plugs: a case series.
PURPOSE: Intracanalicular plugs are commonly used in the management of dry eyes. The authors report 3 cases of complications associated with intracanalicular plugs.
METHODS: Clinical findings and the management of these patients are presented.
RESULTS: The first patient (case 1) is a 47-year-old female with severe dry eyes. Six months after insertion of intracanalicular Form fit hydrogel plugs (OASIS Medical) she developed canaliculitis with Klebsiella oxytoca. The second patient (case 2), a 33-year-old female, who developed left canalicular abscess 5 months following the insertion of bilateral, intracanalicular Form fit hydrogel plugs (OASIS Medical). The third patient (case 3) a 33-year-old female had granulation tissue formation within the left lower canaliculus, 5 years after insertion of intracanalicular plug. The symptoms in the three patients resolved after they underwent canaliculotomy with removal of the plugs.
CONCLUSION: Complications of intracanalicular plugs can sometimes outweigh their benefits. These plugs can lodge in the lacrimal outflow system and cause pyogenic granuloma formation and canaliculitis. To our knowledge, until now there have been no reports of complications associated with Form Fit hydrogel plugs (OASIS Medical) and its infective complication with Klebsiella oxytoca.
METHODS: Clinical findings and the management of these patients are presented.
RESULTS: The first patient (case 1) is a 47-year-old female with severe dry eyes. Six months after insertion of intracanalicular Form fit hydrogel plugs (OASIS Medical) she developed canaliculitis with Klebsiella oxytoca. The second patient (case 2), a 33-year-old female, who developed left canalicular abscess 5 months following the insertion of bilateral, intracanalicular Form fit hydrogel plugs (OASIS Medical). The third patient (case 3) a 33-year-old female had granulation tissue formation within the left lower canaliculus, 5 years after insertion of intracanalicular plug. The symptoms in the three patients resolved after they underwent canaliculotomy with removal of the plugs.
CONCLUSION: Complications of intracanalicular plugs can sometimes outweigh their benefits. These plugs can lodge in the lacrimal outflow system and cause pyogenic granuloma formation and canaliculitis. To our knowledge, until now there have been no reports of complications associated with Form Fit hydrogel plugs (OASIS Medical) and its infective complication with Klebsiella oxytoca.
Joganathan V, Mehta P, Murray A, Durrani OM.
Department of Ophthalmology, James Paget University Hospital, Norfolk NR31 6LA, USA.
I think it's really important to be proactive about plug problems if you have any worry at all. I have known too many doctors to be too aggressive with plugs. I remember one, a well known and respected dry eye doctor in his region, who if his patients couldn't tell their smartplugs were still there would just shove in another pair. Even more than once. Hey, wait, that's durable material floating around in the eyelid... it's simply NOT safe to assume it's flushed out the other side on its own.
My eye is much drier without the plug, worse than I had imagined. I'm being super careful w/keeping it as moist as possible. I didn't have much reflex tearing during the day, but as day winds down toward nite, and I try to force my eyes to focus on the computer, my eye is tearing a lot. What are your thoughts on tearduct cautery?
I have read a number of forum entries on it, but need more info. Have you experienced this yourself? Can you give me an overall estimate of the success rate, complication rate, or where to find this info? I have been reading your blogs
Thanks, Maria