The punctal apposition syndrome: a new surgical approach

Aims: To assess the punctal opposition syndrome (PAS) and its response to lateral canthal tendon (LCT) repair. Methods: In this retrospective, interventional case series, five patients (seven symptomatic eyes) with PAS were managed. Lateral canthal tendon repair was performed in all seven eyes. The main outcome measure was correction of watery eye symptomatology. Results: All five patients achieved symptomatic resolution. Conjunctivochalasis and functional nasolacrimal duct obstruction were associated with the PAS. Conclusion: This new surgical approach to the PAS, using a LCT repair, was successful in all patients. Two patients (three eyes) required conjunctivochalasis excision.