Postherpetic lacrimal obstruction.

OBJECTIVE

The purpose of the study was to review the surgical management of postherpetic lacrimal obstruction.

DESIGN

Retrospective noncomparative case series.

PARTICIPANTS

One hundred sixty patients (111 female, 49 male) with a mean age at presentation of 31 years. All had a history typical of primary herpes simplex blepharoconjunctivitis.

INTERVENTION: Open lacrimal surgery was performed on 158 patients (171 eyes), of whom 99 patients (108 eyes) had undergone no surgery before being seen at Moorfields. The most common primary procedure was dacryocystorhinostomy (DCR) with anterograde or retrograde intubation (94 eyes, 54%), and primary placement of a Lester Jones tube (conjunctivo-DCR) was performed in 56 eyes (32%). A secondary procedure was required in 43 eyes (26%), the most common being closed placement of a Lester Jones tube (40 eyes).

MAIN OUTCOME MEASURES: Persistent symptoms of impaired lacrimal drainage and need for additional surgery.

RESULTS

Reduction of epiphora was good or complete in 171/173 eyes (98%).

CONCLUSIONS

This study shows that there is a justification for procedures that use any remaining unaffected portion of canaliculi, such as DCR, with anterograde or retrograde intubation, as well as the more commonly used Lester Jones tube.