Clinical Atlas of Procedures in Ophthalmic and Oculofacial Surgery

Lacrimal Probing and Intubation

  • Indications for Surgery
  • Preoperative Considerations

Pertinent Surgical Anatomy

  • Anatomy of the lacrimal drainage system

Step by step Surgical Series

  • Placement of pledget under inferior turbinate
  • Dilation of upper punctum
  • Placement of irrigating cannula with fluorescein
  • Complete reflux of fluorescein confirms blokage
  • First segment of canaliculus is vertical
  • Second segment of canaliculus is horizontal
  • Hand stop against the bone as the medial wall of sac
  • Probing of the nasolacrimal duct and schematic view
  • medial fracture of inferior turbinate
  • irrigation with fluorescein and recovery in the inferior meatus
Intubation
  • Grasping of intubation probe at the inferior turbinate
  • Probe is pulled out
  • Second probe is passed
  • Silicone stent is threaded into a 14G needle
  • A small piece of silicone block is used to secure the stent
  • Stents are left with laxity
Before and After photos of Typical Patients
  • Dye Disappearance test
  • Same patient after probing: dye is noe coming out of nose
  • Stent in good position. the inferior punctum is round, without cheese wiring.
  • Complications.

 

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