Canalicular Reconstruction & Repair
Canalicular lacerations are breaks in the normal tear duct drainage system, which originates with the puncta, which acts as a conduit for tears to travel from the eyelid through the nasolacrimal sac into the nose. This type of injury often results from blunt or sharp trauma.
If there is obvious damage, surgery is usually more effective within 48 hours of the injury, once the surrounding tissue swelling has healed. The surgical technique used for canalicular reconstruction and repair will depend on the extent of the patient's injuries, and may be performed under local or general anesthesia.
Balloon Dacryoplasty, also known as balloon dacryocystoplasty, is a surgical procedure that opens a blocked tear duct without making an incision in the nose or face. During the procedure, a thin wire will be inserted through the hole in the corner of the eye, through which tears drain. The wire, which contains a tiny, deflated balloon, is then threaded through to the obstructed area, and the balloon is inflated with a liquid. The pressure of the balloon will open and expand the blocked duct. The balloon will next be deflated, and removed, along with the wire. The procedure is usually performed under deep conscious sedation or general anesthesia in the operating room. As with most operations, antibiotics will be taken for several days after this procedure, in order to prevent infection.
Lacrimal Gland Plication
The Lacrimal Gland is a small, almond-shaped structure, which produces tears and is located just above the upper, outer corner of the eye. The lacrimal gland helps keep the surface of the eye lubricated, and moistened. Excess tears will drain into the small ducts, which empty into the nasal cavity.
If the lacrimal gland protrudes, the condition is usually a result of inflammatory disease, such as sarcoidosis. Symptoms of lacrimal gland dysfunction may include dry eye syndrome. Plication is a surgery which repositions the lacrimal gland, so that tears will be more effectively produced and swelling/protrusion limited.
Lacrimal Gland Biopsy
A Lacrimal Gland Biopsy may be performed if a lacrimal gland growth or enlargement is noted, to rule out malignancies and provide a diagnosis allowing for treatment. Symptoms of lacrimal gland tumors may include eyelid swelling that lasts for several months or pain in this area. A biopsy is usually conducted based on radiographic tests, which will indicate the size of the tumor in the area.
An incisional biopsy, which removes a sample of the growth inside the gland, may be performed if it cannot be determined if the tumor is benign or malignant. Following an incisional biopsy, the specimen will be examined by an attending pathologist. If the tumor is found to be malignant or worrisome the entire gland may be removed.