title: Prevalence of canaliculitis requiring removal of SmartPlugs.
abstract: OBJECTIVE
  To report the first accurate prevalence of canaliculitis associated with the use of the SmartPlug.
  
  
  METHODS
  All patients from a single private ophthalmology practice who received SmartPlugs from 2002 to 2007 were identified. All patients from the private ophthalmology practice that developed canaliculitis secondary to SmartPlug insertion were referred to a single private ophthalmic plastic and reconstructive surgery office. A retrospective review of those 17 patients was performed.
  
  
  RESULTS
  From 2002 to 2007, a total of 235 patients were identified from a single private ophthalmology practice with a total of 402 SmartPlugs inserted. Of those 235 patients, 17 developed canaliculitis and were referred to a single private ophthalmic plastic and reconstructive surgery office. The prevalence of canaliculitis per patient was 7.23%. The prevalence of canaliculitis per SmartPlug inserted was 4.73%. The average time from SmartPlugs insertion to onset of symptoms was 3 years. All affected patients required canaliculotomy and plug removal.
  
  
  CONCLUSIONS
  This is the first study reporting the prevalence of canaliculitis associated with the use of the SmartPlug. All affected patients required surgical intervention, after which many continued to have dry eye and one required bilateral Jones tubes. Ophthalmologists using the SmartPlug for the treatment of dry eye syndrome should carefully weigh the risks and benefits of their use.
authors.affiliation: Department of Ophthalmology, SUNY Upstate Medical University, Syracuse, New York 13210, USA.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Hill
authors.forename: Sylvia W
authors.initials: SW
authors.lastname: Norton
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Bersani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003607:Dacryocystitis / Q000453:epidemiology* / Q000209:etiology* / Q000601:surgery; D020878:Device Removal; D015352:Dry Eye Syndromes / Q000601:surgery; D005260:Female; D006801:Humans; D007765:Lacrimal Apparatus / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D019736:Prostheses and Implants / Q000009:adverse effects*; D019919:Prosthesis Implantation; D012189:Retrospective Studies