Complications associated with silicone intracanalicular plugs.

PURPOSE: To assess American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) member physicians' experiences with complications associated with silicone intracanalicular plugs and publicize risks associated with this device.

METHODS: Two case reports are presented. A survey was sent to 420 ASOPRS member physicians, questioning them on their experiences with complications associated with silicone intracanalicular plugs.

RESULTS: We present two case reports of complications associated with migration of intracanalicular plugs. In the first case, a 41-year-old man underwent serial insertion of seven intracanalicular plugs in one eye over several years, he had a 3-month relapsing course of Nocardia asteroides canaliculitis, dacryocystitis, and cellulitis requiring systemic antibiotics and multiple surgeries. In the second case, a 72-year-old woman had acute dacryocystitis, eventually necessitating dacryocystorhinostomy; at surgery, an intracanalicular plug was discovered in the lacrimal sac. One hundred fifty-nine usable survey responses were obtained. Sixty-one percent of respondents reported various complications including tearing, canaliculitis, and dacryocystitis. Fifty-one percent of respondents performed surgery to treat complications associated with silicone intracanalicular plugs.

CONCLUSIONS: Silicone intracanalicular plugs may be difficult to remove and may be associated with significant lacrimal complications.