Minimally Invasive Punctum-Preserving Canaliculotomy With RS Type Silicone Tube Intubation for Primary Chronic Canaliculitis.

Abstract

To evaluate the efficacy of a minimally invasive punctum-preserving canaliculotomy combined with RS-type silicone tube (RS tube) intubation for treating primary chronic canaliculitis (PCC). This retrospective study included 62 patients (62 eyes) with PCC who underwent the procedure between October 2020 and September 2022. The procedure included punctum dilation, lacrimal probing, a 3 mm conjunctival incision nasal to the punctum, removal of concretions/polypoid tissue through 2 mm curettage, lacrimal irrigation, and RS tube intubation. Tubes were removed at 2 months postoperation. Primary outcomes-anatomical success (patent irrigation, no inflammation) and functional success (anatomic success and absence of epiphora)-were assessed over 12 months. After excluding 7 patients lost to follow-up, 55 patients (55 eyes; mean age 53.2±11.4 y; 37 females) were analyzed. All surgeries were completed within 30 minutes under local anesthesia, with successful tube placement in all cases. At 12 months, all patients exhibited resolved inflammation with no recurrences. Anatomic success was achieved in 98.2% (54/55); one case developed inferior canalicular stenosis. Functional success was 94.5% (52/55), with 2 patients reporting occasional epiphora despite patent irrigation. No procedural complications occurred. Minimally invasive punctum-preserving canaliculotomy with RS tube intubation is a safe and effective treatment for PCC, yielding high anatomic and functional success rates. These results suggest it is a promising alternative to conventional techniques, though larger prospective trials are needed to validate its efficacy.