Pyogenic granuloma formation following placement of the Medennium SmartPLUG punctum plug

Purpose: To report a complication, not previously described, of the Medennium SmartPLUG, which is a new punctal plug with a novel design. Methods: Two case reports are detailed, including clinical and pathologic photographs. Results: Case 1 is a 58-year-old woman with Sjogren syndrome. Nearly 2 years following placement of a SmartPLUG in her right lower canaliculus, the patient presented with an erythematous, papillomatous growth overlying her punctum. Biopsy demonstrated pyogenic granuloma. Case 2 is a 62-year-old woman with dry eye. Exactly 2 years after a SmartPLUG was place in her right lower canaliculus, she also developed a pyogenic granuloma. After irrigation to remove the plug, the growth decreased in size. Conclusion: Pyogenic granuloma can develop as a late complication of the Medennium SmartPLUG punctum plug.