Abstract

Dacryocystorhinostomy is one of the common surgical procedures done in oculoplasty. Dacryocystocele is a diffuse enlargement of the lacrimal sac occurring due to a proximal or a distal obstruction of the lacrimal drainage pathway presenting as a non-inflammatory cystic swelling over the lacrimal sac area as a result of dacryocystitis, trauma, sac surgeries, punctal agenesis or could be idiopathic. We report an unusual case of unilateral acquired dacryocystocele with a distal lower canalicular obstruction and bilateral single punctal agenesis in an adolescent, managed with an external dacryocystorhinostomy and a mono-canalicular silicon tube intubation. The case elaborates on the intraoperative challenges in re-establishing the canalicular pathway using novel technique of canalicular intubation using an IV cannula.