Monocanalicular lesions - To reconstruct or not

Objective: To evaluate the success rate of a simple surgical method for the treatment of a monocanalicular lacrimal lesion. Design: Retrospective noncomparative case series. Participants: Thirteen consecutive patients with monocanalicular trauma who were seen from August 1995 to March 1998. In six patients, the canaliculus was lacerated as a result of an external injury and in seven patients as a result of tumor removal (iatrogenic injury). Intervention: Reapproximation of the orbicularis muscle and skin overlying the torn canaliculus without reanastomosis of the lacerated canaliculus. In those patients in whom the canaliculus was sacrificed as part of the remov al of an eyelid tumor, no attempt was made to reconstruct the canaliculus. Main Outcome Measures: Symptomatology, patency of the lacrimal passage, flu orescein dye disappearance test, and patient satisfaction. Results: In all patients the injured canaliculus was totally blocked, but d espite this none of the patients complained of inconvenient tearing either indoors or outdoors. The ipsilateral unharmed canaliculus was functioning n ormally in such a way that the fluorescein dye instillation test showed res idual dye in six patients after 2 minutes and in none of the patients after 5 minutes. All patients were satisfied with the functional and cosmetic re sult. Conclusion: Nonrepair of a monocanalicular lesion is a valid approach that results in little or no morbidity.