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Physicians should consider risk of canaliculitis after plug insertion for dry eye

Ophthal Plast Reconstr Surg. 2009;25(6):437-439.

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The first study to report prevalence of canaliculitis after insertion of the SmartPlug found that some patients developed the infection and required removal of the device.

"All affected patients required surgical intervention, after which many continued to have dry eye and one required bilateral Jones tubes," the authors said. "Ophthalmologists using the SmartPlug for the treatment of dry eye syndrome should carefully weigh the risks and benefits of their use."

The study looked at 235 patients at a single practice over a 5-year period who received the SmartPlug (Medennium). A total of 402 SmartPlugs were inserted. Cases with infection were retrospectively reviewed.

After insertion, 17 patients developed canaliculitis; there was a 7.23% prevalence of canaliculitis per patient and a 4.73% prevalence of canaliculitis per SmartPlug insertion. Average onset from insertion to symptoms was 3 years, the study found.

All patients with the infection required canaliculotomy and plug removal.