title: A modified technique of retrograde intubation dacryocystorhinostomy for proximal canalicular obstruction.
abstract: OBJECTIVE
  To describe a modification of the retrograde intubation dacryocystorhinostomy (DCR) in patients with proximal canalicular obstruction.
  
  
  METHODS
  Interventional case report of a 43-year-old female with a nine-month history of left epiphora following a road traffic accident involving the proximal lower canaliculus. An external DCR approach was performed. Following the creation of a lower canalicular pseudopunctum, the O'Donoghue silicone stent was introduced through the common ostium, out through the pseudopunctum of the lower canaliculus, and returned through the punctum of the normal upper canaliculus down through the common ostium into the nose.
  
  
  RESULTS
  The patient experienced complete resolution of symptoms and on her last follow-up, two years later, her lower canaliculus was patent to syringing.
  
  
  CONCLUSIONS
  This modification of the retrograde intubation DCR is an effective technique which decreases the intraoperative time needed to insert the tubes and minimises further trauma to the newly created punctal area.
authors.affiliation: Oculoplastic Service, Metropolitan Hospital, Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Trakos
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Mavrikakis
authors.forename: Kostas G
authors.initials: KG
authors.lastname: Boboridis
authors.forename: Marselos
authors.initials: M
authors.lastname: Ralidis
authors.forename: George
authors.initials: G
authors.lastname: Dimitriadis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Mavrikakis