Ampullary pyogenic granuloma as a complication of lacrimal plug migration.

We present a patient with ampullary pyogenic granuloma caused by spontaneous migration of a silicone lacrimal plug. A 43-year-old woman with severely dry eyes was treated with non-absorbable silicone punctal plugs insertion in both superior and inferior puncta. Irritation and purulent discharge gradually developed 3 weeks after implantation. A pink, fleshly ampullary lesion over the left superior punctum was noted later. The migrated silicone plug was found close to the common canaliculus during surgery. Histopathologic examination confirmed the diagnosis of pyogenic granuloma. A migrated lacrimal plug resulting in pyogenic granuloma is a rare complication. The treatment of choice is removal of the migrated plug as early as possible. Patients with lacrimal plugs insertions should be informed of possible complications and should be followed up regularly for early detection of plug-related problems.