Table 2.

Summary of surgical approaches

Mild	Moderate	Severe
LCT repair	Plication of MCT posterior limb	Medial tarsal strip
± medial spindle	or	or
± open punctum	LCT repair	MCT resection (posterior limb) with canaliculus intubation/marsupialisation
± resection of caruncle/semilunar fold	± medial spindle
	± open punctum,	or
	± resection of caruncle/semilunar fold	MCT plication
		± LCT repair