Modified Jones’ Lacrimal Bypass Surgery with an Angled Extended Jones’ Tube
Presented at: European Society of Ophthalmic Plastic and Reconstructive Surgery 24th Meeting, September 2006, London, United Kingdom.
Received 25 June 2006; accepted 5 October 2006. published online 06 February 2007.
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.
Lacrimal Clinic, Department of Ophthalmology, University Hospital Leuven, Leuven, Belgium.
Correspondence to Ilse Mombaerts, MD, PhD, University Hospital Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium.
Manuscript no. 2006-696.
The authors have no financial or commercial interests in the product discussed in the article.
ABSTRACT