Lacrimal Deroofing for the Management of Epiphora from Lacrimal Punctal-Canalicular Abnormalities

Background: Epiphora significantly impacts daily activities. The application of the punctum-canaliculus continuum concept is crucial for the optimal management of epiphora. Purpose: To evaluate the efficacy of the lacrimal deroofing in the management of epiphora caused by lacrimal punctal-canalicular abnormalities.Patients and Methods: This prospective study included 39 eyes that underwent proximal lacrimal deroofing. Lacrimal apparatus evaluation was conducted including severity of epiphora and grading of punctal stenosis. The lacrimal deroofing procedure involved the restoration of lacrimal punctum, 2-snip punctoplasty, and posterior canaliculotomy.Results: The severity of epiphora and punctal grading significantly improved at the 6-month follow-up. The mean baseline Munk scale score decreased from 3.8 ± 0.6 to 0.3 ± 0.6. The mean baseline punctal grading increased from 1.1 ± 0.5 to 3.2 ± 0.7. The anatomical success rate was 97.4%, and functional success was achieved in 89.7% of cases.Punctal canalicular stenosis was observed in 30 eyes, while lacrimal canaliculitis was diagnosed in 9 eyes. Conclusion: This technique is a safe and effective procedure in the management of punctal-canalicular stenosis and lacrimal canaliculitis.