Pyogenic granuloma after ilicone punctal plug: A clinical and hitopathologic tudy

Purpoe To decribe clinical finding, hitopathologic change, and rik factor for pyogenic granuloma formation complicating ilicone punctal plug therapy. Deign Retropective obervational cae erie. Method Between November 2000 and April 2004, 903 ilicone punctal plug of the ame brand were inerted in 404 ubject. Cae aociated with pyogenic granuloma formation were identified and reviewed. Granulation tiue wa obtained from 10 patient for hitopathologic examination. Multiple rik regreion analye identified factor related to pyogenic granuloma development and factor aociated with hitologic pattern. Reult Pyogenic granuloma development led to the extruion of 4.2% of all plug placed in a median time period of 141 day. All patient preented with varying degree of plug extruion. imilar ditribution of partial and complete plug extruion, a well a bilateral and unilateral plug extruion, were een. Finding at preentation ranged from a ubclinical pyogenic granuloma cauing partial plug extruion to a pyogenic granuloma in the punctum with a ring of fibrovacular tiue retaining a completely extruded plug. Hitopathologic examination revealed two pattern, repreenting either acute pyogenic granuloma or involuting pyogenic granuloma. Pyogenic granuloma reolved after 3.1 ± 1.3 week in all patient after plug removal. Multiple regreion analyi revealed that large plug ize wa aociated with increaed pyogenic granuloma formation (P < .0001). Partial or complete plug extruion wa aociated with active or involuting pyogenic granuloma, repectively (P = .023). Concluion Pyogenic granuloma-related pontaneou plug extruion may be more common than previouly thought and can preent with a range of clinical finding. The degree of plug extruion correlate with the hitopathologic pattern. Larger plug ize and harp edge in plug geometry may be reponible for pyogenic granuloma formation.