A 42-year-old man presented with a white
plastic-like material exposed in the left medial canthal area, with a
fistula and purulent discharge. He had undergone endonasal
dacryocystorhinostomy 7 years earlier for left eye
epiphora; he had persistent postoperative
epiphora and recurrent
dacryocystitis despite multiple drainage attempts and
antibiotics elsewhere. Computed tomography showed bilateral enlarged cystic lacrimal sacs, with a well-defined contoured tunnel-like hole at the center of the left sac. Treatment included excision of the
foreign body, which was a Griffiths' collar button nasolacrimal
stent, excision of the
fistula tract, and revision
dacryocystorhinostomy with implantation of bicanalicular
silicone stent. He recovered with no further symptoms or complications. This case highlights the importance of follow-up for removal of an implanted Griffiths'
stent after
dacryocystorhinostomy. Patients with recurrent
dacryocystitis may benefit from a detailed history of previous surgery, careful examination, and imaging to evaluate for endogenous and exogenous
foreign bodies such as lacrimal sac
calculi, and retained lacrimal sac
stents.