Modified canaliculo-dacryocystorhinostomy.

The management of cases with common canalicular obstruction poses a difficult problem. Nineteen patients presenting with common canalicular obstruction of unknown cause or in association with trauma, encysted mucocoele and previous sac surgery, were operated on by the modified canaliculodacryocystorhinostomy technique. The surgery involves a microsurgical dissection at the site of the common canalicular obstruction followed by anastomosis to the sac or nasal mucosa with silicone tube intubation of the passage using an improvised metallic introducer. The procedure was successful in 13 of the cases in a follow-up period varying from 4 months to 15 months. The complications included extrusion of the tube and nasal bleeding. The indications of the procedure, the precise technique and precautions to avoid intra and post operative complications have been elaborated in the paper.