Bowman probe-guided lacrimal canalicular repair using a 24-G intravenous cannula: a retrospective case series

AbstractPurpose: The primary goal in traumatic lacrimal canalicular lacerations is to restore canalicular continuity and prevent permanent epiphora. This study evaluated anatomical and functional outcomes and postoperative complications of Bowman probe-guided repair using a 24-gauge intravenous cannula in urgent cases where commercial canalicular stents were unavailable.Materials and methods: This retrospective single-center case series included patients undergoing primary canalicular repair with this technique between January 2022 and December 2025. Patients with incomplete records or follow-up shorter than 3 months were excluded. Demographics, injury characteristics, surgical details, cannula retention, follow-up, success rates, and complications were recorded. Anatomical success was defined as lacrimal patency on irrigation at final follow-up; functional success as absence of epiphora (Munk score 0).Results: Twenty-one patients (15 male; mean age 36±16 years) were included. The lower canaliculus was most frequently involved. Fifteen patients underwent repair within 24 hours; 19 underwent concurrent eyelid repair. Mean cannula retention and follow-up were 3.8±1.0 and 9.5±2.7 months, respectively. Anatomical and functional success were achieved in 18 (85.7%) and 17 (81.0%) patients, respectively. Complications included corneal abrasion in 3 (14.3%), early cannula loss in 2 (9.5%), and canalicular stenosis in 1 (4.8%). No punctal granuloma or wound infection occurred.Conclusion: Bowman probe-guided canalicular repair using a 24-gauge intravenous cannula achieved favorable early-to-intermediate anatomical and functional outcomes with manageable complications in this limited series. In urgent cases without commercial stents, it may be considered a readily available alternative. These findings should be supported by prospective studies with larger sample sizes.