Pyogenic granuloma: a rare complication of silicone punctal plugs

To describe pyogenic granuloma formation associated with silicone punctal plugs. A 65-year-old woman with severe dry eye was treated with silicone punctal plugs in both upper and lower puncta. After 14 months of success with the plugs, the patient presented with a fleshy ampullary lesion overlying the plugged superior punctum of her right eye. It was clinically diagnosed as a pyogenic granuloma, and the silicone plug was removed. Since the lesion persisted for 1 month, it was surgically removed. Histopathologic examination confirmed the diagnosis of pyogenic granuloma. A new plug was inserted and tolerated well. The routine use of silicone plugs are recommended as long as patients are informed of possible rare complications.