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. 2022 Dec 6;37(11):2289–2293. doi: 10.1038/s41433-022-02333-7

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© The Author(s), under exclusive licence to The Royal College of Ophthalmologists 2022. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

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Fig. 2 — A A horizontal incision was made along with the canaliculus, keeping the punctum intact and starting 2 mm medial to the punctum. B The overall length of the inferior canaliculus’s horizontal incision is approximately 6 mm in this patient. C A bicanalicular silicone tube was inserted into the inferior and superior puncta through the lacrimal system, and the incision was sutured.