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Reversal of iatrogenic punctal and canalicular occlusion
1Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, TX 77030, USA.
Purpose:
Significant epiphora occasionally develops after therapeutic punctal occlusion. When this complication occurs from combined scarring of the upper and lower proximal canaliculi, correction usually requires a conjunctivodacryocystorhinostomy.
Methods:
The authors describe a new microsurgical technique for reversing iatrogenic occlusion of both the upper and lower canaliculi. The relatively straightforward reconstruction uses the remaining canalicular system to create new tear outflow sites.
Results:
This procedure has been used successfully to repair eight of nine consecutive cases of iatrogenic canalicular occlusion, with an average follow-up of 2 years.
Conclusion:
Iatrogenic canalicular occlusion can be reversed microsurgically without a conjunctivodacryocystorhinostomy.