Microsurgical Reconstruction for Eyelid Margins & Severed Tear Ducts
Lacerations of the medial eyelid frequently involve the delicate lacrimal canaliculus—the micro-channel responsible for draining tears into the lacrimal sac and nasal cavity. If a severed tear duct is simply sutured as ordinary skin, the canal permanently scars shut, causing lifelong epiphora (uncontrollable watery eye). Furthermore, poor eyelid margin approximation produces traumatic colobomas, corneal exposure, and inward (entropion) or outward (ectropion) turning of the lid.
The Microsurgical Repair Protocol
Dr. Vishal Purohit utilizes specialized oculoplastic and microsurgical techniques to reconstruct injured eyelids:
- Canalicular Identification & Stenting: Identifying the medial severed end of the microscopic tear duct under operating magnification and threading a Mini-Monoka or Crawford silicone stent across the laceration to keep the lumen open.
- Pericanalicular Microsuturing: Suture approximation of the pericanalicular fibrous sheath using 8-0 or 9-0 absorbable micro-sutures without passing needles directly through the delicate epithelial lining.
- Three-Point Eyelid Margin Alignment: Exact alignment of the meibomian gland orifices, grey line, and eyelash line with vertical mattress sutures to guarantee a completely smooth eyelid contour against the eyeball.
Long-Term Eye Comfort and Function
The silicone stent remains comfortably in place for 6 to 8 weeks while the duct heals around it, after which it is painlessly removed in the clinic, restoring normal tear drainage and protecting eyesight.