Reconstruction of absent lacrimal puncta

A previously described technique to isolate absent lacrimal puncta is reemphasized. The procedure has been modified, whereby the entire punctal and vertical canalicular walls are removed with a Holth sclerectomy punch and by silastic intubation of the passages. This has led to increased permanent patency of the lacrimal puncta and a greater, successful resolution of epiphora. A modified pigtail probe with a narrowed tip has been developed to facilitate passage of the silastic tubing without it slipping off the probe.