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Canalicular ligation - alternative to puntal cautery

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  • Canalicular ligation - alternative to puntal cautery

    Just found this article:

    http://www.osnsupersite.com/view.asp?rID=18680

    "In the technique, a full thickness, vertical eyelid margin incision is made perpendicular to the gray line and 2 mm nasal to the punctum. It is continued to the horizontal portion of the canaliculus without disturbing the ampulla or punctum. The surgeon then oversews both the proximal and distal canalicular ends and sutures the eyelid margin incision anteriorly and centrally."

    You may have to register to read the article. I copied the abstract below, but the article has more details. I read it a few times and still don't entirely understand how this works, though.

    As someone who is tired of dealing with plugs and considering cautery, this seems like a pretty attractive option. It is reversible and seems to block tear drainage. Has anyone on here had this done?



    A Permanent and Reversible Procedure to Block Tear Drainage for the Treatment of Dry Eye.

    Ophthalmic Plastic & Reconstructive Surgery. 22(5):352-355, September/October 2006.
    DeMartelaere, Sheri L. M.D. *; Blaydon, Sean M. M.D. *; Tovilla-Canales, Jose Luis M.D. +; Shore, John W. M.D. *

    Abstract:
    Purpose: To describe a technique of canalicular ligation and report observations on 59 consecutive surgeries.

    Methods: Retrospective, non-comparative case series of canalicular ligation by 3 surgeons over a 7-year period.

    Results: Fifty-nine eyelids of 29 patients (2 men and 27 women) underwent canalicular ligation for the treatment of severe dry eyes. Patient age ranged from 34 to 90 years. Average length of follow-up was 20 months. There were no complications. Ninety-one percent of patients noted an improvement in their symptoms. Two patients developed symptomatic epiphora more than 1 year postoperatively and both underwent successful reversal.

    Conclusions: Canalicular ligation is an effective technique for punctal occlusion in patients with severe dry eyes. It combines surgical ease with excellent cosmetic outcomes.

  • #2
    Sounds more invasive than cautery to me.

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    • #3
      I believe I would go the cautery route before that. I'm guessing you would have less scar tissue with the cautery.

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      • #4
        Cautery

        I have both lower ducts cauterized with plugs in the top ducts. There is no noticeable scaring at all. It was painless except for the injection which was a momentary pain. No pain afterwards except for a little swelling. And it lasted no more than 2 days. There is no way I'd opt for this procedure. I'd go with cauterization.

        Billye

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