[The clinical study of lacrimal bypass surgery with high-density porous polyethylene coated tear drain implantation].

OBJECTIVE

To analyze the outcomes of lacrimal bypass surgery using the high-density porous polyethylene (HDPP) coated tear drain and to evaluate the validity and safety of this procedure.

METHODS

Twenty-six patients (26 eyes) with severe epiphora who could not be cured by canaliculo-anastomosis and dacryocystorhinostomy were treated by the lacrimal bypass surgery with the HDPP coated tear drain. HDPP tube insertion: 10 patients with defect of the punctum or the canaliculi and in the presence of lacrimal sac were treated by conjunctiva-dacryocystorhinostomy with HDPP coated tear drain implantation. 16 patients with defect of the punctum or the canaliculi and without lacrimal sac were treated by simple HDPP coated tear drain insertion.

RESULTS

No tube extrusion or severe malposition occurred after 4 - 28 months follow-up. Complete or significant improvement of epiphora was achieved in 88.5% cases. Most patients (80.8%) satisfied with the therapeutic result of this procedure. Complications included obstruction (9 eyes), discomfort (4 eyes), improper tube length (2 eyes), malposition (1 eye), infection (1 eye), diplopia (1 eye), abrasion of cornea (1 eye) and nasal secretion countercurrent (1 eye).

CONCLUSIONS

The lacrimal bypass surgery with the HDPP coated tear drain could be expected to improve epiphora significantly in most cases of lacrimal obstruction. This surgery has a higher successful rate and fewer complications than that of Jones tube insertion and is a safe and efficient procedure.