A Case of Acquired Lacrimal Fistula Caused by Silicone Tube Remnant

Yong Ju Song; Ji Seong Jeong; Seong Won Yang

doi:10.3341/jkos.2014.55.5.746

Journal List > J Korean Ophthalmol Soc > v.55(5) > 1009972

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Song, Jeong, and Yang: A Case of Acquired Lacrimal Fistula Caused by Silicone Tube Remnant

Case Report

J Korean Ophthalmol Soc 201;55(5):746-749.

Published online: 30 August 2014

DOI: https://doi.org/10.3341/jkos.2014.55.5.746

A Case of Acquired Lacrimal Fistula Caused by Silicone Tube Remnant

Yong Ju Song, MD, Ji Seong Jeong, MD, Seong Won Yang, MD, PhD

Department of Ophthalmology, Chosun University College of Medicine, Gwangju, Korea

Address reprint requests to Seong Won Yang, MD, PhD, Department of Ophthalmology, Chosun University Hospital, #365 Pilmun-daero, Dong-gu, Gwangju 501-717, Korea, Tel: 82-62-220-3190, Fax: 82-62-225-9839, E-mail: master@ smarteyes.co.kr

Received 12 October 2013 Revised 17 December 2013 Accepted 1 April 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a case of acquired lacrimal fistula caused by silicone tube remnant.

Case summary

A 56-years-old female who suffered from purulent discharge in inner skin of the right lower eyelid visited our clinic. Lacrimal fistula was found in the skin at the medial side of the right lower eyelid. The patient reported that she had a silicone tube intubation operation 3 years prior due to a nasolacrimal obstruction of right eye. On syringing test, saline solution and purulent discharge were drained from the fistula skin opening and there was no nasolacrimal obstruction. After admission, antibiotic treatment and potadine soaking dressing were performed to facilitate spontaneous closing of the lacrimal fistula. However, the lacrimal fistula relapsed and lacrimal fistulectomy and bicanalicular silicone tube intubation were performed. During surgery, silicone tube remnant material not totally extubated at the lacrimal sac was found which we removed. Postoperatively, systemic antibiotic therapy was administered and the chronic inflammation improved.

Conclusions

We report a case of lacrimal fistula caused by silicone tube remnant in the lacrimal sac. Acquired lacrimal fistula caused by a silicone tube remnant can be treated by fistulectomy and silicone tube remnant removal.

Keywords: Acquired lacrimal fistula, Silicone tube remnant

References

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Figure 1.

Acute purulent dacryocystitis was treated with incision followed by drainage: there was a noticeable improvement following the incision site being sutured. However, the lacrimal fistula still persisted.

Figure 2.

A remnant of silicone tube found at the lacrimal sac.

Figure 3.

Histiology slide of tissue from the lacrimal duct area: In low power field, areas of aggregated lymphoid cells (arrow) and fibrosis (black star) are noted, implying that there is chronic inflammation with fibrosis.

Figure 4.

Following the fistulectomy and bicanalicular silicone tube intubation: no further sign of inflammation or fistula observed.

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