Management of Complications after Conjunctivodacryocystorhinostomy with Jones Tube

ABSTRACT

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.