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Removal of the vertical portion of the lacrimal canaliculus in dry eye syndrome

PURPOSE: To demonstrate the efficacy and possible complications of a surgical technique that includes the removal of the vertical portion of the lacrimal canaliculus in patients with dry eye syndrome. METHODS: A study was performed on six canaliculi of six eyes (four patients). Three patients had dry eye, associated with primary Sjögren syndrome. One of the four patients developed keratoconjuntivitis sicca due to lacrimal gland removal. The criteria included: patients with symptoms of dry eye that did not improve even with the continuous use of artificial tears, low results (less than 5 mm) with the Schirmer test, rose bengal staining and cases of recanalization after thermal occlusion with electrocauterium. The lacrimal puncta were examined after 7, 15, 30, 60, 90 and 180 days after surgery. RESULTS: None of the canaliculus recanalized at this time. Punctate keratitis, corneal filaments, Schirmer and rose bengal tests improved in 5 eyes. Difuse punctate keratitis was present in the patient with lacrimal gland removal even 2 months after of surgery. Eyelid margin complications were not observed. CONCLUSION: This technique is simple and effective in permanent lacrimal canaliculus occlusion. We did not note any complications compared to other procedures.

Dry eye syndromes; Lacrimal apparatus; Ophthalmologic surgical procedures


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