목적 : Herrick 실리콘 눈물점 마개에 의한 만성 육아종성 눈물소관염을 보고 하는 바이다. 대상과 방법 : 4개월 전부터 양안 유루증과 분비물을 주소로 내원한 56세 여자환자로 내원 시 양안 아래 눈물점의 변형과 눈물소관내의 분비물이 관찰되었다. 눈물소관염의 진단 하에 눈물점 성형술과 눈물소관 내 소파술을 시행하고 눈물점 성형술시 얻은 눈물소관의 일부에서 조직학적 검사를 시행하였다. 결과 : 소파술을 시행할 당시 눈물소관에서 눈물점마개를 제거하였으며 조직학적 검사에서 만성 육아종성 눈물소관염으로 진단되었다. 상기 시술 후 현재 유루증 및 전안부 증상이 소실되었다. 결론 : 영구적 눈물점의 폐쇄 시 사용되는 Herrick 실리콘 눈물점 마개는 드물지만 눈물 배출계의 이상을 초래해 눈물흘림을 나타낼 뿐만 아니라 이물질로 작용하여 염증을 일으키기 때문에 반드시 필요한 경우에 제한적으로 사용하고 주의깊은 관찰이 필요하다.

Purpose: To report the experience of treating chronic granulomatous canaliculitis induced by permanent silicone punctal plugs used for dry eye syndrome treatment. Methods: The transformation of puncta below both eyes and secretions in the lacrimal duct were observed for a 56-year-old female patient who had attended hospital for 4 months due to epiphora and secretions. Under the diagnosis of lacrimal duct inflammation for the lower lacrimal duct of both eyes, three-snip punctoplasty, curettage in the lacrimal duct, and pathological examination on the part of the lacrimal duct obtained from the three-snip punctoplasty were carried out. Results: The lacrimal silicone plugs were removed from the lacrimal duct at the time of the lacrimal duct curettage, and a diagnosis was made based on tissue biopsy of chronic granulomatous canaliculitis induced by permanent silicone punctal plugs. After the above surgical operations, the epiphora and the anterior eye segment symptom both disappeared. Conclusions: The permanent silicone punctal plug used to permanently close the lacrimal punctum scarcely causes disorder in the lacrimal drainage system with epiphora and inflammation by acting as a foreign substance. It therefore should only be used when essential.

Purpose: To report the experience of treating chronic granulomatous canaliculitis induced by permanent silicone punctal plugs used for dry eye syndrome treatment. Methods: The transformation of puncta below both eyes and secretions in the lacrimal duct were observed for a 56-year-old female patient who had attended hospital for 4 months due to epiphora and secretions. Under the diagnosis of lacrimal duct inflammation for the lower lacrimal duct of both eyes, three-snip punctoplasty, curettage in the lacrimal duct, and pathological examination on the part of the lacrimal duct obtained from the three-snip punctoplasty were carried out. Results: The lacrimal silicone plugs were removed from the lacrimal duct at the time of the lacrimal duct curettage, and a diagnosis was made based on tissue biopsy of chronic granulomatous canaliculitis induced by permanent silicone punctal plugs. After the above surgical operations, the epiphora and the anterior eye segment symptom both disappeared. Conclusions: The permanent silicone punctal plug used to permanently close the lacrimal punctum scarcely causes disorder in the lacrimal drainage system with epiphora and inflammation by acting as a foreign substance. It therefore should only be used when essential.

Chronic granulomatous canaliculitis, Herrick silicone punctual plug