OBSTRUCTION of the medial end of the common canaliculus or the internal common punctum is usually associated with either a complete or functional block of the nasolacrimal duct. In these cases, a simple dacryocystorhinostomy will not cure the epiphora. Previously, a conjunctivodacryocystorhinostomy, using a Jones tube, was the treatment of choice. The following is a much simpler surgical procedure we have been using to alleviate this problem.
Once the lacrimal sac has been opened, a lacrimal probe is placed in the canaliculus. The probe will not enter the sac because of the obstructed area (Fig 1). The tissue in front of the probe is grasped with a finetooth forceps and excised until the probe moves freely into the lacrimal sac (Fig 2). Care must be taken to excise any bands of tissue that are seen as the probe moves past the area of previous obstruction. The tissue removed is the
Tenzel RR. Canaliculodacryocystorhinostomy. Arch Ophthalmol. 1970;84(6):765. doi:10.1001/archopht.1970.00990040767014