title: Spontaneous Canalicular Plug Erosion After Punctal Plug Placement.
abstract: OBJECTIVE
  To describe a case of keratoconjunctivitis sicca treated with punctal plug placement with the first reported complication of subsequent plug erosion through the canaliculus and extrusion through the lid.
  
  
  METHODS
  Punctal plugs were placed in a patient with Sjogren syndrome for treatment of keratoconjunctivitis sicca. More than 12 years later, the plug was noted to have eroded through the canaliculus and extruded through the conjunctiva and lid.
  
  
  RESULTS
  The extruded plug was removed, and punctal cautery was performed on 2 other puncta with improved symptom control.
  
  
  CONCLUSIONS
  Plug extrusion through the conjunctiva and lid is a possible consequence of punctal plug placement.
authors.affiliation: *Department of Ophthalmology, Marshall University, Huntington, West Virginia; and †Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Xinxin
authors.initials: X
authors.lastname: Zhang
authors.forename: Maya
authors.initials: M
authors.lastname: Bitar
authors.forename: Richard M
authors.initials: RM
authors.lastname: Davis
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007638:Keratoconjunctivitis Sicca / Q000473:pathology / Q000601:surgery*; D011475:Prosthesis Failure; D019919:Prosthesis Implantation; D000070635:Punctal Plugs; D012859:Sjogren's Syndrome / Q000473:pathology / Q000601:surgery*