Fifty-four patients ( 75 eyes ) with presaccular lacrimal obstruction , including 3 cases ( 5 eyes ) of upper and lower lacrimal punctum atresia , 15 cases ( 24 eyes ) of superior and inferior canalicular obstruction , 18 cases ( 28 eyes ) of common canaliculus obstruction , 18 cases ( 18 eyes ) of old laceration of superior and inferior canalicular , were recruited .