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.
3-snip punctoplasty (MP4 83704 kb)
Endoscopic dacryocystorhinostomy (DCR) (MP4 610430 kb)
Endoscopic conjunctivodacryocystorhinostomy (CDCR) (MP4 485031 kb)