Reconstruction of lacrimal drainage remains a problem in spite of refinements in surgical technique. Frequent failures can be expected in canalicular repair1: reanastomosis of the lacrimal sac to nasal mucosa; comminuted fractures of the medial canthal region; and tumor involvement of the medial one third of the lower eyelid. When the ensuing tearing is excessive in such conditions, various methods of reconstructing lacrimal drainage have been recommended.2-7 Results with these generally have been inconsistent.8,9
In 1937, Jameson10 attacked the problem by dividing the secretory ductules of the palpebral lacrimal gland. Experience with this procedure usually results in undercorrection of the epiphora.
In 1952, Duke-Elder11 summarized experience with excision of either lobe of the lacrimal gland:
"Excision of the lacrimal gland, or, which amounts to the same thing, of the palpebral lobe, in the great majority of cases has no serious ill-effects. Sufficient lubrication being obtained