Delayed Canaliculoplasty in Unrepaired Canalicular Laceration

ABSTRACT

PURPOSE: Conjunctivodacryocystorhinostomy with a Jones tube has been the standard treatment for canalicular obstruction secondary to unrepaired canalicular laceration. We sought to evaluate the efficacy of delayed canaliculoplasty with bicanalicular silicone intubation for patients whose canaliculi were not repaired by initial surgery. METHODS: We retrospectively studied the medical records of 4 patients who had bicanalicular obstruction from previous unrepaired canalicular laceration. After careful dissection through the scarred medial canthal region, canaliculoplasty with bicanalicular silicone intubation was performed. The time interval from initial trauma to canaliculoplasty was between 5 months and 10 years. Follow-up periods ranged from 3 weeks to 13 months. RESULTS: All of the canaliculi were reanastmosed. Epiphora disappeared in two, occurred intermittently in one, and persisted in the last at 3 weeks postoperatively. CONCLUSIONS: Delayed canaliculoplasty was functionally effective in three out of four patients. Even though canalicular reconstruction was delayed for a long time, attempting canalicular reconstruction would be recommendable before considering conjunctivodacryocystorhinostomy with a Jones tube.