A novel surgical technique for bicanalicular intubation without the use of a standard bicanalicular intubation set.

PURPOSE: To describe a modified technique for bicanalicular intubation using standard lacrimal instruments when bicanalicular intubation set is unavailable or malfunctions intraoperatively. METHODS: A modified bicanalicular intubation technique using an olive-tip Bowman probe, silicone tubing, and a 5-0 Vicryl suture is described. Seven consecutive lacrimal procedures in which the bicanalicular intubation set malfunctioned or became detached intraoperatively were included; one traumatic bicanalicular laceration repair, two closed dacryointubations, and four dacryocystorhinostomies. RESULTS: In all cases, successful silicone tube placement was achieved using the described technique despite intraoperative malfunction or detachment of the bicanalicular intubation set. No false passage formation, tube malposition, or postoperative extrusion were observed during follow-up. CONCLUSION: The described technique offers a practical and reproducible rescue alternative for successful bicanalicular intubation following intraoperative malfunction or detachment of the bicanalicular intubation set.