How much MCT laxity is required before you will repair the MCT?

Does your decision to repair the MCT vary if the patient presents with epiphora?

What is your preferred method of MCT repair? Do you tighten the anterior limb, posterior limb or both? What type of suture and needle, etc, are used? Do you cut/shorten the elastic canaliculus? If so, do you intubate?

What is your management in severe cases with such gross MCT laxity that the whole inner canthus complex (including caruncle and upper and lower MCT) is distractable laterally?