Lacrimal Disorders

  • Geoffrey J. GladstoneEmail author
  • Timothy Ekhlassi
  • Kathryn P. Winkler


Epiphora can be caused by a stenosis of the punctum and vertical canaliculus. A single vertical incision in the canaliculus will allow access to the lacrimal system, for irrigation or tube placement, but restenosis will occur promptly. A 3-snip punctoplasty removes the internal wall of the vertical canaliculus allowing similar access and restenosis will not typically occur (Video 8.1). Mitomycin C can be applied at the end of the procedure to increase the success rate.

Supplementary material

Video 8.1

3-snip punctoplasty (MP4 83704 kb)

Video 8.2

Endoscopic dacryocystorhinostomy (DCR) (MP4 610430 kb)

Video 8.3

Endoscopic conjunctivodacryocystorhinostomy (CDCR) (MP4 485031 kb)

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Geoffrey J. Gladstone
    • 1
    • 2
    • 3
    Email author
  • Timothy Ekhlassi
    • 4
  • Kathryn P. Winkler
    • 5
  1. 1.Consultants in Ophthalmic and Facial Plastic Surgery, PCSouthfieldUSA
  2. 2.Oakland University William Beaumont School of MedicineRoyal OakUSA
  3. 3.Wayne State University School of MedicineDetroitUSA
  4. 4.Consultants in Ophthalmic and Facial Plastic SurgerySouthfieldUSA
  5. 5.Kresge Eye Institute, Wayne State University School of MedicineDetroitUSA

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