To introduce a modified technique of bicanalicular silicone tube intubation, which can reduce slitting of the canaliculus and protrusion of the tube.

This study included 46 patients who underwent modified surgery for Congenital Nasolacrimal Duct (CNLD) obstruction. To be included in this study, patients were older than 13 months and had a history of failed probing. Using our modified technique, tube lengths can be appropriately adjusted by either pulling or releasing the tube at the medial canthus until a tube loop is in place without any tension to the upper and lower canaliculi. Two threads of silicone tube were tied together using 5-0 nylon over a silicone sponge (5×5 mm) and left within the nasal cavity for several months without fixation to the nasal mucosa. A successful surgery was clinically defined as no epiphora and no dye retention in the conjunctival sac.

The mean age of patients at the time of surgery was 32.8 (±18.9) months. There were 22 males and 24 females. Prior to intubation, patients had been probed an average of 1.5 (±1.3) times, and the mean follow-up period was 12.6 (±14.2) months. The tube was removed at 5.4 (±1.3) months postoperatively on average. The success rates were 88%. Tube protrusions occurred in three eyes, and canalicular splittings were recorded in two eyes. No other serious complications were encountered.

This new technique might enable us to remarkably reduce both protrusion and slitting of the canaliculus in bicanalicular silicone intubation for congenital nasolacrimal duct obstruction.