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    Identifying and Retrieving Lodged Punctal Plugs via Lacrimal Endoscopy

    By Juwan Park, MD; Soonwon Yang; Geunyeong Kim; Suk-Woo Yang; Andrew R. Harrison, MD
    AAO 2015
    Oculoplastics/Orbit

    Punctal plugs lodged in the lacrimal system can result in canaliculitis or dacryocystitis. To identify and retrieve a lodged punctal plug, lacrimal syringing and probing are often performed. Eventually, retrieval of the plug can be done by open surgeries such as a canaliculotomy or dacryocystorhinostomy, which can leave permanent changes in the lacrimal drainage pathway. It is also an oxymoron to perform a dacryocystorhinostomy in a patient with an underlying dry eye syndrome. In this video, the authors introduce a safe, fast, and easy way to identify and retrieve lodged punctal plugs under direct visualization using a 0.9-mm-diameter lacrimal endoscope. With this technique, the entire lacrimal drainage pathway can be thoroughly examined and the lodged plugs can be retrieved along the drainage pathway without damaging the lacrimal system.