Reversal of iatrogenic punctal and canalicular occlusion.
OBJECTIVE
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.


CONCLUSIONS
Iatrogenic canalicular occlusion can be reversed microsurgically without a conjunctivodacryocystorhinostomy.
Pratt
D V
DV
Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, TX 77030, USA.
Patrinely
J R
JR
D000328:Adult; D003608:Dacryocystorhinostomy; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007765:Lacrimal Apparatus / Q000601:surgery; D007767:Lacrimal Duct Obstruction / Q000209:etiology; D008866:Microsurgery / Q000379:methods*; D019736:Prostheses and Implants; D013518:Surgery, Plastic / Q000379:methods