Pediatric canalicular tear repairs--revisiting the pigtail probe

Repairing canalicular lacerations can be complicated by difficulty in identifying and intubating the proximal injured system, retrieving stents in the nose, and repairing canalicular epithelium. We describe a hybrid method of repair that alleviates these challenges by the use of an eyelet-type pediatric pigtail probe and a self-threading monocanalicular stent. The pigtail probe is inserted through the intact punctum and canaliculus on the injured eyelid and rotated to identify the medial edge of the torn canaliculus. The stent is threaded through the injured punctum and pigtail probe, drawn back out the intact puncta, and cut flush. The eyelid is repaired without direct suturing of the canaliculus. When we applying this technique to 10 children, we successfully intubated the injured system without complication, and all children had good anatomic and clinical results, with negative dye disappearance tests.