Modifications of the conjunctivodacryocystostomy procedure.

I modified the conjunctivodacryocystostomy procedure in 36 patients (43 eyes) by directly threading the pre-flanged PE-190 polyethylene tubing over a No. 3 or 4 Bowman probe into and through the nasolacrimal duct, contrary to the original intranasal maneuvers. This simplified the procedure but caused minor amenable complications such as shortening the tubing postoperatively. In eight of 43 eyes, replacement or shortening the tubing was easily done in the office over a handleless Bowman probe. In three of the 43 eyes, polyethylene tubing was occasionally plugged, requiring cleansing or replacement. Of the 43 tubes inserted, 42 are still in place and functioning.