Epiphora: a quick fix?

Purpose To assess whether any simple, easily performed and minimally invasive procedure may help the symptoms of patients with functional nasolacrimal obstruction without recourse to elaborate investigation or major surgery. A randomised study was performed to assess the success of retropunctal cautery (RPC) and one-snip punctoplasty in this condition. Methods In the absence of any cause for excess lacrimation, eyelid malposition or nasolacrimal obstruction, patients underwent either syringing alone (group A, n = 15) or syringing with RPC and a one-snip punctoplasty (group B, n = 15). Results Three months after treatment, six patients in group A were improved, compared with 13 in group B (Fisher's exact test, p = 0.0096). Conclusions We would recommend that patients who suffer from a pump or functional nasolacrimal obstruction should receive RPC and a one-snip punctoplasty following the demonstration of a patent system on syringing. These simple procedures would not impair further investigation or lacrimal surgery if required in the future.