Conjunctivodacryocystorhinostomy with mucous membrane graft

Eleven patients with obstructed lacrimal canaliculi underwent conjunctivodacryocystorhinostomy modified by lining the fistula with buccal mucosa at the time of surgery. Four patients had the tube removed after six months. All four have parent mucous membrane lined fistulas with follow-up ranging from ten to 13 months. One patient removed his tube on the second post-operative day. His fistula closed immediately. For comparison, the remaining six patients retain their tubes. They are free from epiphora but suffer from some of the complications of the tube itself, namely tube extrusion, tube migration, and chronic conjunctival irritation and discharge. The surgical technique is described, histopathologic material is presented, and the initial results are discussed.