Successful correction of abnormal tear flow from eye (epiphora) by Dacryocystorhinostomy with medial canthopexy

A 34-year-old lady reported to our hospital with a complaint of continuous tears running down her face from her left eye. She gave a history of having met with a car accident.  Due to the traumatic injury, it was identified that the medial canthal ligament of her left eye had detached and come down. A defect in her nasolacrimal duct caused epiphora or abnormal tear flow. The normal flow of tears from the eye to the nose was damaged.

The aim of the surgery was to correct the defect in the nasolacrimal duct with DCR or Dacryocystorhinostomy & reposition the medial canthal ligament. The ostium was opened with rongeurs, bone adjacent to nasolacrimal sac was removed. A new direct communication was created between the nasolacrimal sac & the nasal mucosa by placing a silicone tube to enable the tears to drain into the nose. The medial canthal ligament was repositioned using Y-plate canthopexy. 

Displaced medial canthus due to traumatic injury

Dacryocystorhinostomy surgery for correction of abnormal tear flow

Ostium opened and direct communication created between nasolacrimal sac & nasal mucosa using silicone tube

X-ray taken after surgery showing Y plate used to reposition medial canthal ligament

Medial canthal ligament repositioned and epiphora corrected following DCR surgery