Primary TSP showed an 86% success rate with the resolution of tearing by an average of 1.2 months post-operatively. Membrane formation or scarring over the surgical site required an additional TSP with stenting in 14% of patients. All 50 eyes eventually achieved functional success. TSP alone as a primary procedure is a safe, relatively simple, and effective treatment of epiphora caused by punctual stenosis. Stenting should be explored as an adjunct to this procedure if primary TSP alone does not produce resolution of symptoms.

There was no statistically significant difference in pain scores or surgical outcomes in patients receiving frontal nerve block compared with those receiving subconjunctival injection during CMMR surgery.

This is the first reported case of successful canalicular transplantation. Although a single case report, the authors anticipate future success with this technique.

PurposeDetermine the impact of upper eyelid weight placement at 3 months post onset of idiopathic facial paralysis (IFP) on the recovery of facial function in patients with lagophthalmos.MethodsThis is a retrospective review of patients with incomplete recovery of IFP—defined as a Sunnybrook Facial Grading Scale (FGS) score of less than 100, 3 months after onset. Only patients with FGS and Facial Clinimetric Evaluation (FaCE) scores recorded at 3 and 12 months were included. Patients were categorized into 3 groups: Group A, lagophthalmos with eyelid weight placement; Group B, lagophthalmos without eyelid weight placement; Group C, complete eye closure (CEC) without eyelid weight placement. The eye comfort domain and composite score of the FaCE questionnaire were analyzed. Voluntary eye closure, synkinesis with eye closure, overall synkinesis and the composite score of the FGS were also analyzed. Paired two‐tailed t‐test was used to evaluate the data comparing the 3 and 12 month FaCE and FGS scores within and between the 3 groups.ResultsThe change in composite FGS score significantly increased from month 3 to month 12 in Group A as compared to Group B (37 vs 4.25, P = 0.01). While Group A had significantly lower eye comfort (−12.5, P = 0.01), voluntary eye closure (−1.75, P = 0.05) and overall FGS scores (−28.75, P = 0.04) at 3 months compared to those in Group C, there were no differences between these two groups at 12 month follow‐up.ConclusionsFor patients with lagophthalmos at 3 months, early eyelid weight placement may lead to improved facial function at 12 months.

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