Treatment of canalicular block.

Canalicular obstructions especially those of the inferior canaliculus present some of the most difficult problems in lacrimal surgery. Before surgery, the clinical examination must elicit the degree of discomfort and the length and position of the stenosis. If the stenosis is partial, a bincanalicular intubation is the treatment of choice, but if the stenosis is on the punctum or in the common canaliculus, or if the stenosis is limited, conservative surgery should be used. If the stenosis is long, one of the best methods of obtaining lacrimal drainage is by the use of Jones' procedure. However because post-operative complications are common this method has been modified by the use of a silicone tube introduced into the naso-lacrimal duct. This has now been performed for over 10 years.

[A new method of lacrymal derivation in the canalicular obstruction (author's transl)]. / Un nouveau traitement du larmoiement canaliculaire: une modification de la technique de Jones.

The authors believe that in their experience the best method of lacrymal derivation in the canalicular obstruction is the Jone's technique. However, the post operatoire complications are numerous in this method and therefore they are looking for a new procedure of lacorhinostomy: - the type of tube is a silicone tube which has the great advantage of not irritating the tissues; - the silicone tube is introduced into the lacrymal duct. After having used this technique for four years the authors are convinced that this is the best method.

[Lacrimal physiology (author's transl)]. / La physiologie lacrymale.

The althors want to recall the importance of the quality of the lacrymal film. The role of the accessory lacrymal glands is essential. The excretory system is not a passive emunctory but an active pumping system, the walls of the passages absorb most of the lacrymal fluid. Easy tests enable to probe the lacrymal system.