Study on Dry Eye Syndrome and Lacrimal Punctal Size

PURPOSE: To evaluate the diagnostic value of lacrimal punctal size in patients with dry eye. METHODS: We analyzed 55 patients (110 eyes) who underwent lacrimal punctal plug insertion in dry eye from June to November 2003. We performed BUT and Schirmer test, inquired about the symptoms of dry eye, and measured lower lacrimal punctal size by Punctal Gauging System(R). RESULTS: The mean number of symptoms of dry eye was 4.24 +/- 1.14, 4.57 +/- 1.22, 5.75 +/- 1.00, and 6.95 +/- 0.91 in lower lacrimal punctal size 0.5mm, 0.6mm, 0.7mm, and 0.8mm, and the mean BUT was 4.86 +/- 1.59 sec, 3.94 +/- 1.69 sec, 3.25 +/- 1.57 sec, and 3.53 +/- 0.96 sec, respectively. These differences were statistically significant (p0.05). CONCLUSIONS: These results suggest that an increase of lacrimal punctal size decreases the BUT results and causes discomfort for patients with dry eye symptoms. Thus, an increase of lacrimal punctal size is the causative factor of dry eye, and the measurement of lacrimal punctal size is thought to be helpful to diagnose dry eye and choose the size of lacrimal punctal plug.

Management of Complications after Conjunctivodacryocystorhinostomy with Jones Tube

PURPOSE: To analyze the surgical outcomes of conjunctivodacryocystorhinostomy(CDCR) with Jones tube on the postoperative management of complications. METHODS: We retrospectively analyzed the medical records of 87 eyes (79 patients) with at least 3 months follow-up who had undergone CDCR with Jones tube between January 1993 and December 2002. The patients were divided into several cases according to the results of postoperative management. RESULTS: Thirty eyes (34%) experienced no complications of Jones tube, over a mean follow-up period of 26.77 +/- 34.41 months. Forty-five eyes (52%) were improved by postoperative management of complications, over a mean follow-up period of 45.00 +/- 42.70 months. In these 45 eyes, the medial migration of the tube was corrected in 7 eyes after repositioning without fixed suture, in 9 eyes after repositioning with fixed suture, in 10 eyes after endonasal endoscopy-assisted repositioning with fixed suture, and in 1 eye after endonasal endoscopy-assisted tube exchange. The lateral migration of the tube was corrected in 1 eye after repositioning with fixed suture, and in 7 eyes after endonasal endoscopy-assisted tube exchange with fixed suture. The extrusion of the tube was corrected in 3 eyes after endonasal endoscopy-assisted tube reinsertion with fixed suture. Consecutive dacryocystitis improved in 1 eye after tube exchange with dacryocystectomy. The conjunctival obstruction of the tube was corrected in 6 eyes after resection of conjunctival tissue. Twelve eyes (14%) were not improved by CDCR or postoperative managements of complications, over follow-up period of 38.50 +/- 35.39 months. CONCLUSIONS: The complications of Jones tube occurred anytime during the postoperative period. If extrusion of the tube occurred reinsertion had to be done as soon as possible. Migration or obstruction of the tube was mostly improved by postoperative managements.