Suture-assisted punctoplasty.

Purpose To describe a surgical technique in which a suture, instead of forceps, is used to improve access for the introduction of scissors and more easily achieve an appropriately-sized punctoplasty. Materials and Methods In this technique, a new modification of the 2-snip punctoplasty, a 6-0 polyglactin 910 suture is passed through the posterior wall of the punctum to apply traction. A video of the technique is provided. Results This technique improves the surgical field of view and eases access for introduction of Vannas scissors into the punctum to perform the punctoplasty. Conclusions This simple and practical modification of the 2-snip punctoplasty improves instrument access so that an appropriately-sized punctoplasty can be performed with ease.