Lacrimal mechanics in the enucleated state

Our understanding of tear-flow mechanics is based upon work performed on eyes in the normal, nucleated state. On this basis, decisions are made regarding the reconstruction of lacerated canaliculi. When called upon to repair such a laceration in a patient who is coincidentally undergoing a traumatic enucleation, the surgeon has traditionally done so when it was practical. This assumes that the tear-flow requirements in these patients are similar to those of patients in the nucleated condition. We have investigated twelve patients after traumatic enucleation and believe, based on this preliminary work, that eyes in the enucleated state may not have the same tear-flow requirements and therefore may not require canalicular reconstruction.