Iatrogenic complications related to the use of Herrick Lacrimal Plugs

Purpose. To report a series of lacrimal complications associated with a spe cific type of lacrimal plug (Herrick Lacrimal Plug; Lacrimedics Incorporate d, Rialto, CA.) Design: Retrospective, noncomparative case series and survey. Methods. Members of the American Society of Ophthalmic Plastic and Reconstr uctive Surgery were asked to submit personally treated cases of patients re ferred for treatment of complications after placement of a Herrick Lacrimal Plug. Main Outcome Measures: Failure of the device to be removed by simple lacrim al irrigation. Results. The clinical courses of 41 patients were analyzed. Patients ranged in age from 19 to 81 years, and all had symptomatic epiphora related to th e presence of the lacrimal plug. Several interventions were used to treat l acrimal obstruction. Nasolacrimal duct probing with irrigation was used in 15 lacrimal systems, whereas six systems were probed and subsequently stent ed with silicone tubing. Eyelid margin cutdown was used in eight cases. Bal loon dacryoplasty was performed in three systems, dacryocystorhinostomy in 18 instances, and conjunctivodacryocystorhinostomy in two patients. Conclusions: The Herrick lacrimal occlusion device sometimes cannot be remo ved by simple irrigation and is capable of inducing permanent, irreversible , symptomatic lacrimal drainage system obstruction. Ophthalmology 2001;108: 1835-1837 (C) 2001 by the American Academy of Ophthalmology.