title: Bilateral canaliculitis following SmartPLUG insertion for dry eye syndrome post LASIK surgery.
abstract: BACKGROUND
  Dry eyes are a common symptom following LASIK corneal refractive surgery. Treatments include topical lubricants to supplement the tear film, and punctal occlusion to reduce tear outflow. Canaliculitis is a recognised complication of punctal plugs, but has not previously been described following insertion of newer generation semi-permanent intra-canalicular plugs, such as the SmartPLUG.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  We describe a 60-year-old female who underwent bilateral LASIK surgery leading to aggravation of her dry eye syndrome. She was managed with the insertion of semi-permanent intra-canalicular moldable silicone SmartPLUGs. She subsequently developed bilateral canaliculitis requiring bilateral canaliculotomy.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the first report of bilateral canaliculitis following intra-canalicular SmartPLUG insertion. This case illustrates that punctal occlusion with the newer generation intra-canalicular plugs carries a risk of canaliculitis and that irrigation is not always effective in removing these devices.
authors.affiliation: Royal Berkshire Hospital, Reading, Berkshire, RG1 5AN, UK.
authors.forename: Marius
authors.initials: M
authors.lastname: Scheepers
authors.forename: Andrew
authors.initials: A
authors.lastname: Pearson
authors.forename: Michel
authors.initials: M
authors.lastname: Michaelides
mesh_terms: D003607:Dacryocystitis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D020878:Device Removal; D015352:Dry Eye Syndromes / Q000209:etiology / Q000601:surgery*; D004653:Empyema / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D007765:Lacrimal Apparatus / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications; D019736:Prostheses and Implants / Q000009:adverse effects*; D019919:Prosthesis Implantation; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery