Incomplete extrusion of an acrylic punctum plug in a case of severe dry eye syndrome

PURPOSE. To report a case of extrusion of a new soft punctum plug with thermoexpansion property (Medennium SmartPLUG). METHODS. A soft punctum plug was implanted in a 32-year-old woman with a severe dry eye syndrome in juvenile arthritis. RESULTS. One week after implant the plug partially extruded outside the punctum. Despite this adverse event, all subjective dry eye symptoms improved. CONCLUSIONS. The peculiarity of this case is the persistence of clinical efficacy of the soft punctum plug even if partially extruded. The patient experienced relief of symptoms that can be compared to the benefits usually obtained with a successfully implanted silicon plug.