Alternative to the 3-snip operation for lacrimal drainage insufficiency.

'The following procedure, which is suggested as an alternative to the above operations, can be used in combination with other plastic operations for ectropion of the lower lid. The object of the operation is to provide a new round opening into the lower canaliculus, 2 mm. below the original punctum. The instruments required are a Nettleship dilator, j-size Bowman's probe or similar size silver-wire (I have used a lacrimal canaliculus syringe needle instead), a 1 5-mm. trephine (preferably one set aside for this operation), sharp pointed scissors, and a straight iris forceps.