title: Role of Lacrimal Canalicular Trephination and Mini-Monoka Stent in the Management of Idiopathic Distal Canalicular Obstructions: Our Experience of 23 Cases.
abstract: OBJECTIVE
  Different techniques have been mentioned in literature for management of idiopathic lacrimal canalicular obstructions. The aim of this study was to report surgical outcomes with use of Sisler's lacrimal trephine and role of Mini-Monoka monocanalicular stent in patients of idiopathic distal canalicular obstructions.
  
  
  METHODS
  This was a prospective, interventional case series.
  
  
  METHODS
  Twenty-three patients of idiopathic distal canalicular obstruction were managed surgically from August 2011 to October 2012. Lacrimal canalicular trephination was done in all followed by on-table syringing and Mini-Monoka stent insertion.
  
  
  RESULTS
  There were 15 women and 8 men. Mean age of patients was 50.33 ± 12.06 years. Average duration of complaints was 20.58 ± 23.01 months. Twenty-four eyes were included in the study. Common canalicular obstruction was present in 15 eyes (62.5%), whereas 9 (37.5%) had distal lower canalicular obstruction. Mini-Monoka stent was kept in place for a minimum of 8 weeks. Twenty eyes (83.33%) reported absent epiphora, whereas 2 eyes (8.33%) reported improvement at average post-stent removal follow-up of 8.66 ± 3.17 months. No significant complication was observed in intraoperative and postoperative period except for 2 spontaneous tube extrusions, which were managed with tube reinsertion.
  
  
  CONCLUSIONS
  Lacrimal canalicular trephination with Mini-Monoka stent insertion is an easy, monocanalicular and lesser invasive technique, which has never been reported earlier in literature. We conclude that this repeatable procedure has good anatomical and functional success rates with minimal complications as compared with the other available treatment modalities for lacrimal canalicular obstructions.
authors.affiliation: From the Department of Ophthalmology, Advanced Eye Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Zoramthara
authors.initials: Z
authors.lastname: Zadeng
authors.forename: Manpreet
authors.initials: M
authors.lastname: Singh
authors.forename: Usha
authors.initials: U
authors.lastname: Singh