A 79-year-old patient showed left conjunctival injection and bilateral epiphora for years. He was diagnosed with left lower eyelid medial ectropion and bilateral lacrimal obstructions. Lacrimal syringing and a dacryoendoscopic examination showed left upper and lower canalicular obstructions and a right common canalicular obstruction. Canaliculoplasty was performed to the obstruction sites directly by the dacryoendoscope. Bilateral bicanalicular intubation was performed with a three-piece segmented tube. Just after the procedure, the left lower eyelid medial ectropion was also improved. The tubes were left in place for 2 months. The tear meniscus had been well reconstructed and the ectropion continued to improve during this period. Six months postoperatively, the medial ectropion was further improved with an appropriate tear meniscus height.