Ophthalmology · 2007
Modified Jones' lacrimal bypass surgery with an angled extended Jones' tube.
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Mombaerts Ilse, Colla Brigitte
Аннотация
PURPOSE: To analyze the outcome of modified Jones' lacrimal bypass surgery with an angled extended tube.
DESIGN: Retrospective, noncomparative, interventional case series.
PARTICIPANTS: Patients with epiphora due to severe canalicular obstruction or dysfunction. Seventy-one Caucasian patients (90 tubes), operated between 1995 and 2005, were followed over a mean period of 3.2 years, ranging from 2 months to 10.4 years after surgery.
INTERVENTION: A modified Jones' tube, with a 130-degree angled middle and extended length, was inserted using a transcaruncular technique without a dacryocystorhinostomy. In 6 tubes, an additional external dacryocystorhinostomy was performed for reasons of concurrent dacryomucocele.
MAIN OUTCOME MEASURES: Patency and anatomic position of the tube and subjective relief of epiphora.
RESULTS: The tube complications included nasal displacement in 12% of the tubes, lateral displacement in 11%, and nonpatency in 4%. The conjunctival complications were conjunctival overgrowth and caruncular granuloma, observed in 6% of the tubes. In all but 4 eyes, complications occurred within 2.7 months after the first tube implantation. After secondary surgery for a complication, 40% of the eyes needed a third intervention or more. The patients reported a comfortable relief of epiphora in 89% of the well-positioned patent tubes.
CONCLUSION: The modified Jones' tube offers a good long-term outcome, with a tube displacement rate of 23%, mainly occurring within the first 3 months after surgery.
DESIGN: Retrospective, noncomparative, interventional case series.
PARTICIPANTS: Patients with epiphora due to severe canalicular obstruction or dysfunction. Seventy-one Caucasian patients (90 tubes), operated between 1995 and 2005, were followed over a mean period of 3.2 years, ranging from 2 months to 10.4 years after surgery.
INTERVENTION: A modified Jones' tube, with a 130-degree angled middle and extended length, was inserted using a transcaruncular technique without a dacryocystorhinostomy. In 6 tubes, an additional external dacryocystorhinostomy was performed for reasons of concurrent dacryomucocele.
MAIN OUTCOME MEASURES: Patency and anatomic position of the tube and subjective relief of epiphora.
RESULTS: The tube complications included nasal displacement in 12% of the tubes, lateral displacement in 11%, and nonpatency in 4%. The conjunctival complications were conjunctival overgrowth and caruncular granuloma, observed in 6% of the tubes. In all but 4 eyes, complications occurred within 2.7 months after the first tube implantation. After secondary surgery for a complication, 40% of the eyes needed a third intervention or more. The patients reported a comfortable relief of epiphora in 89% of the well-positioned patent tubes.
CONCLUSION: The modified Jones' tube offers a good long-term outcome, with a tube displacement rate of 23%, mainly occurring within the first 3 months after surgery.