A 65-year-old woman presented to the Ophthalmology outpatient clinic with a foreign body sensation and a reddish pigmented tumor in the left internal corner.
Examination revealed the presence of a granulomatous lesion in the lower lacrimal point.
This was a patient who had been under control for 4 years in outpatient Ophthalmology clinics for presenting a dry eye syndrome that was observed in the different examinations performed in the second SchUTis test in 5 mm.
He had received various treatments with different types of lumps without notice of significant improvement.
Persistent chronic discomfort was implanted tear-like PLUG- lacrimal glands in the lower canaliculus of both eyes, and it was recommended to continue with the treatment 0.5%, mild remission lasting 6 months.
The worsening of his discomfort was treated with oral Pilocarpine 5 mg every 8 hours (Salagen®), with temporary relief.
Later, one year after the implant, pilocarpine was suspended due to its ineffectiveness and a new SMART-PLUG was implanted in the superior canaliculus of the left eye without appreciating it.
He also received treatment with autologous serum eye drops first and topical cyclosporine later without clinical benefit so that these eye drops were removed receiving only artificial preservative treatment.
Three years after the first implant, the patient came to the emergency department for presenting a granuloma in the inferior canaliculus of the left eye that was removed at that time.
Two weeks later, the patient came to the outpatient clinic for granuloma recurrence.
The implant was removed by transcutaneous canaliculotomy in the operating room, performing debridement and cleaning of the canaliculus.
No catheter or canalicular device was implanted.
After surgery, the infectious condition disappeared, and no recurrence of the granuloma was observed to date.
