Canalicular resection and reconstruction by canaliculostomy

A procedure is described for externalizing residual lower canaliculus in an "ostomy" manner after lower lid resection. As little as one-fourth residual canaliculus can be used. The basis of this technique involves intubation of the residual canalicular stump and the upper canaliculus with silicone tubing after the method described by Quicker-Dryden, the micro-dissection of the canalicular remnant and its placement on the internal edge of the eyelid margin. This canaliculostomy technique may be combined with different eyelid reconstructive procedures. The technique has been applied to patients undergoing eyelid resection for neoplastic disease, patients with medial cicatrical canthal deformity and congenital eyelid abnormalities. Following the canaliculostomy procedure all patients were symptomatically free from epiphora; however, in certain cases which were available, physiologic flow of tears through the new canalicular opening was documented by performing the Jones No 1 dye test with occlusion of the upper punctum with ointment.