Treatment of dry eye by moving the lacrimal punctum to dry dock.

Several methods for occluding the lacrimal canaliculi to prevent spontaneous drainage have been described for the treatment of dry eye. These techniques have been either of short duration or irreversible. We have developed a technique in which the vertical portion of the lacrimal canaliculus is transferred anteriorly, and the lacrimal punctum is placed between the eyelashes, where it is out of the lacrimal meniscus and therefore nonfunctional. If the quantity of lacrimal secretion improves, the vertical portion of the lacrimal canaliculus may be returned to its original site, allowing normal lacrimal flow. The technique was successful in 12 puncta of seven patients with more than 5 years of follow up. The operation was easily reversed in the two puncta of one patient who complained of epiphora after lacrimal secretion had improved, allowing spontaneous tear drainage.