Anterograde Reconstruction of Severe Bi-Canalicular Obstruction with Autogenous Saphenous Vein Graft: A Novel Surgical Technique.

Severe lacrimal canalicular obstruction mandates a bypass surgery of conjunctivo dacryocystorhinostomy with Lester Jones tube or alternatively retrograde intubation and pseudopunctum generation with conventional, dacryocystorhinostomy (DCR). However, in each case, the natural pathway is violated and added commitment of Lester Jones tube maintenance often leads to patient dissatisfaction. This novel surgical technique aims at de novo, anterograde, reconstruction of lacrimal canaliculi and rehabilitation of the natural lacrimal passage with interposition of autogenous saphenous vein graft. This method offered promising long-term results of functional success in terms of alleviation of epiphora, excellent cosmesis, and an optimal patient satisfaction.