Reversal of iatrogenic punctal and canalicular occlusion.

PURPOSE: 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.

CONCLUSION

Iatrogenic canalicular occlusion can be reversed microsurgically without a conjunctivodacryocystorhinostomy.