Fig. 44 A. Silastic intubation is required after excision of scars in the area of the common internal punctum and for moderate degrees of canaliculostenosis or obstruction. The probes are placed through the upper and lower canaliculi and through the common internal punctum. Any scar tissue over this area is excised. B. The Silastic is brought down through the dacryocystorhinostomy (DCR) window and cuffed as described earlier. This type of tubing with a cuff will suffice as a stent in these instances, and will maintain separation of the anterior and posterior mucosal flaps. Use of this tubing eliminates the need for a catheter or for packing to act as a stent.