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Corneal burn grade IV usually leads to blindness. Several different surgical techniques remain challenging owing to the extensive tissue damage. Here, we introduce a novel technique with a 15 mm corneoscleral and limbal homologous graft combined with sequential autologous corneal removal ab interno, with a vitrectomy probe to save the anterior chamber angle. In vivo anatomy with optical coherence tomography is the surgical key. A large 15 mm sclerocorneal graft is sutured on top of the remainder of the destroyed cornea and sclera after removal of the epithelium and conjunctiva, with anterior synechiolysis if necessary, peripheral iridectomy and conjunctivoplasty. The recipient central corneal stroma is not removed, primarily to protect the anterior chamber angle. After three weeks, the collagenolytic central recipient corneal stroma can be removed with a small 23 g vitrectomy probe, respecting the lens and scleral spur. The corneoscleral graft remains clear under systemic and local immunosuppression. Intraocular pressure is well controlled because the anterior chamber angle is respected. Recurrent corneal erosions need close follow-up. Therapeutic soft contact lenses can support topical therapy. In cases of sclercorneal graft decompensation or rejection after 3-5 years, a new sclerocorneal graft (with limbal donation) seems to be superior to perforating keratoplasty without limbal stem cell transplantation. Repeated sclerocorneal grafts after severe corneal burn with limbal transplantation and maintenance of the complete anterior angle structure are a successful option for preventing blindness and achieving good visual acuity. Clin. Anat. 31:39-42, 2018. © 2017 Wiley Periodicals, Inc., (© 2017 Wiley Periodicals, Inc.)

Epiphora is a common clinical symptom of nasolacrimal duct obstruction. However, it is present in several pathologies and can lead to decreased quality of life for patients. A careful clinical examination including a detailed patient's history and diagnostic tests such as the fluorescein dye disappearance test and diagnostic syringing of the lacrimal duct are essential. Depending on the time of presentation (congenital, primary, or secondary acquired), grade (subtotal or total) and location of the stenosis, different surgical approaches can be considered. These are subdivided into minimally invasive (transcanalicular) and anastomosing (dacryocystorhinostomy) procedures. Furthermore, the anatomical landmarks and the site of surgical intervention differentiate the surgical techniques into endoscopic or transcutaneous. Modern intubation techniques offer a large spectrum of therapeutic possibilities enabling patient care to be customized and individualized. Knowledge of the topographical anatomy is crucial for achieving greater success and a lower complication rate. Clin. Anat. 30:1034-1042, 2017. © 2017 Wiley Periodicals, Inc., (© 2017 Wiley Periodicals, Inc.)