Microsurgical reconstruction of destroyed canaliculi lacrimales.

The authors describe the microsurgical technique applied for the primary and secondary reconstruction of destroyed lacrimal canaliculi. In the event of fresh injuries, they recommend the immediate repair of the mucosal tissue and the reconstruction of the muscle tissue after direct or retrograde intubation of the lumina canaliculi. For secondary reopening of a stenosis, depending on the localization and the extent of the injury, various methods can be used, such as retrograde probing, the opening of the canaliculus in the area of the punctum papilla as described by Arlt,, retrograde opening from the tear sac in the manner used by Sattler or from the canaliculus communis following the method of Busse and colleagues. In the event that a substitute is necessary, then the authors recommend the implantation of a hydrophilic tear duct prosthesis in combination with a conjunctivodacryocystostomy in the manner descibed by Stallard.