New minitrephine makes lacrimal canalicular rehabilitation an office procedure

A new minitrephine, with a stainless steel tube of 0.81-mm outer diameter, 16-mm length, a plastic hub and handle assembly for manual rotation, Luer lock attachment to either standard or specially designed 3-ml syringe with spring-assisted plunger, and an intraluminal stylet--all disposable--has been designed by us principally for opening a distally occluded lacrimal canaliculus prior to stenting with any desired implant. Local anesthesia via a nasociliary nerve block makes this an office procedure. Other potential uses include transscleral globe biopsies of suspected malignancies, intraorbital biopsies, drainage of fluid-filled spaces wherein a beveled needle evacuation might undesirably pierce the far end of the cyst--all with possible ultrasonic monitoring--or the creation of a correctly sized, round, noncollapsible passage for a Molteno valve stenting of the anterior chamber, for intractable glaucoma.