Dacryocystitis secondary to neglected silicone tube in lacrimal duct for 10 years

Abstract

Introduction: Contracture of dacryocyst by an implanted lacrimal silicone tube is rare. This report describes a unique case of secondary dacryocystitis and the contracture of dacryocyst caused by a lacrimal silicone tube that was placed in the lacrimal system for 10 years. Patient concerns: A 63-year-old female was diagnosed with chronic dacryocystitis at a local hospital and underwent surgical treatment 10 years ago. In the past month, the patient complained of persistent tearing and purulent secretion from the eyes. Diagnosis: The patient was diagnosed with secondary dacryocystitis, based on clinical features and the presence of the silicone stent, granulation tissue formation, and dacryocyst contracture in the lacrimal duct, as observed by nasal endoscopy. Interventions: For treatment, the implanted silicone tube in the patient was removed, the lacrimal duct and nasal mucosa was anastomosed, and a new lacrimal silicone tube was placed again. Outcomes: Following the surgery, the patient recounted that there were no symptoms, and follow-up examinations performed over a 1-month period posttreatment revealed no recurrence of obstruction or dacryocystitis. Therefore, the surgeon removed the lacrimal drainage tube and asked the patient to return to the outpatient department regularly for examination. Conclusion: The findings, in this case, suggest that silicone tubes are safe and effective, and can be placed in the lacrimal drainage system. However, in this patient, prolonged intubation caused chronic inflammation, granulation tissue formation, and dacryocyst contracture. Our findings could inform surgeons to consider the reasonable duration of intubation for treating cases of lacrimal obstruction, in order to avoid unnecessary complications.