University of Iowa Health Care

Ophthalmology and Visual Sciences

Crawford Stent Rescue

Richard C. Allen, MD, PhD, FACS

Additional Notes: Length 02:40

Posted Feb 10, 2017

This is Richard Allen at the University of Iowa. This video demonstrates rescue of a bicanalicular stent. The patient has had an attempt at placing the Crawford stent through the upper canaliculus. Unfortunately, a soft stop was encountered as demonstrated with the Bowman probe. Options to address this include canalicular cut down or the procedure demonstrated in this video.  Previously, the stent was able to be successfully placed through the lower canaliculus, nasolacrimal duct, and retrieved from the nose. Therefore, a pigtail probe is placed through the lower punctum and canaliculus and then through the upper canaliculus and retrieved from the upper punctum. A 6–0 nylon suture is then placed through the eye of the pigtail probe and rotated through to the lower punctum. The other end of the Crawford stent is then placed over the nylon suture which goes through the upper punctum. The stent is then fixated to the nylon suture and rotated through the system and retrieved from the lower punctum. After the stent is retrieved from the lower punctum, it is fixated to the other end of the stent which had been placed previously placed through the lower punctum. This is performed with the same 6-0 nylon suture. The end of the stent that had be previously retrieved from the nose can then be pulled from the nose. This results in pulling both the stent from the upper and lower canaliculus down the nasolacrimal duct and into the nose. The stent can then be tied and allowed to retract into the nose, completing bicanalicular intubation.

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last updated: 02/22/2017
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