Fig. 59 Surgical repair of the supernumerary duct. A. Methylene blue is injected into the duct with the lacrimal cannula; an ellipse is cut through the skin and muscle. Using a probe as a guide, careful dissection is completed to the connection of the duct to the sac. B. The supernumerary duct is ligated at its junction at the sac with a 5–0 absorbable suture, and cut. C. The subcutaneous tissue and skin are closed with appropriate interrupted sutures.