Use of a modified monocanalicular silicone stent in 33 eyelids.

Background And Objective: To determine (1) whether a modified monocanalicular silicone stent fixated to the peripunctal tissues by a 6-0 polypropylene suture is a practical alternative to bicanalicular intubation for canalicular reconstruction, and (2) whether this technique is superior to previously described methods of monocanalicular intubation.

Patients And Methods: The charts of patients from the Oculoplastics Division of the Ophthalmology Department at the UMDNJ Medical School who had undergone insertion of a modified canalicular stent were retrospectively reviewed from April 1, 1991, to April 1, 1995.

Results: The technique was used successfully in 33 eyelids (32 patients) for the following conditions: (1) unicanalicular (17 eyelids) and bicanalicular lacerations (1 eyelid), (2) reconstruction of a single canaliculus after eyelid tumor resection (5 eyelids), (3) after canaliculotomy for canaliculitis refractory to medical treatment (3 eyelids), and (4) after punctal plasty for congenital punctal agenesis and after a three-snip procedure for acquired punctal stenosis (6 eyelids). Tubes were maintained in position for a median of 11.5 weeks. Complications included erosion of the anterior aspect on the lid margin (1 eyelid) and premature tube extrusion (1 eyelid) that required reinsertion of another monocanalicular stent. All patients had normal results on dye disappearance tests after surgery and no patients experienced postoperative tearing.

Conclusions: The monocanalicular silicone stent is technically simple to perform and is an effective method of monocanalicular intubation that may avoid the need for bicanalicular intubation in certain circumstances.