title: Silicone punctal plug migration resulting in dacryocystitis and canaliculitis.
abstract: OBJECTIVE
  One of the modalities of treating dry eyes is punctal plugs. They are usually used for temporary occlusion of the lacrimal drainage system. Among the complications associated with silicone punctal plugs are extrusion, downward migration, irritation, and epiphora. To our knowledge, this is the first report of dacryocystitis and canaliculitis as a result of spontaneous migration of punctal plugs into the lacrimal drainage system.
  
  
  METHODS
  We describe the sequelae of spontaneous migration of silicone punctal plugs into the lacrimal drainage system in two patients with dry eyes.
  
  
  RESULTS
  In two patients, spontaneous migration of silicone punctal plugs into the canaliculus or the lacrimal sac, respectively, resulted in canaliculitis or dacryocystitis.
  
  
  CONCLUSIONS
  Smaller sized newer generation punctal plugs were designed to facilitate insertion; however, this design also increases the likelihood of proximal migration within the lacrimal drainage system. The importance of monitoring patients after punctal-plug placement cannot be over-emphasized.
authors.affiliation: Department of Ophthalmology, Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, USA.
authors.forename: S
authors.initials: S
authors.lastname: Rumelt
authors.forename: H
authors.initials: H
authors.lastname: Remulla
authors.forename: P A
authors.initials: PA
authors.lastname: Rubin
mesh_terms: D000328:Adult; D000368:Aged; D003607:Dacryocystitis / Q000209:etiology* / Q000601:surgery; D003608:Dacryocystorhinostomy; D015352:Dry Eye Syndromes / Q000628:therapy; D005260:Female; D005548:Foreign-Body Migration / Q000150:complications* / Q000601:surgery; D006801:Humans; D007440:Intubation / Q000009:adverse effects / Q000379:methods; D007767:Lacrimal Duct Obstruction / Q000209:etiology*; D012826:Silicone Elastomers / Q000009:adverse effects*
chemical_list: D012826:Silicone Elastomers