A threaded lacrimal bypass drainage device uses a threaded cannula or tube for greater axial friction and adjustability. The tube has a keyed flange for engagement by a keyed screwdriver-type tool having a trocar coaxially engaging the tube and providing a distal cutting blade. A removable, coaxial, biocompatible washer discourages tissue overgrowth of the tube immediately after emplacement. One or more radial drainage holes formed near the distal end of the tube overcome axial blockages. Adjustments to the axial position of the tube can be readily made during successive office visits by the patient.
