Treatment of Obstructed Lacrimal Apparatus by Bowman's Probe Guided Lacrimal Bypass Surgery

ABSTRACT

The purpose of this study is to evaluate clinical utility of lacrimal bypass surgery using Bowman's probe In treatment of obstruction of the lacrimal apparatus. The lacrimal bone was penetrated between lacrimal sac and nasal mucosa through the incised caruncle with Bowman #0 probe. A Jones tube was Introduced over the probe into the nasal cavity and fixed at caruncle with non-absorbable suture material. Epiphora was completely resolved in 120 (96.8%) of 124 eyes for mean follow-up of 17.1 months. Only 4 eyes failed to reach resolution of epiphora. Postoperative complications were as follows. coverage of the tube with conjunctiva in 10 eyes (8.1%), recurrent migration of tube to the nasal cavity 7 eyes(5.6%), persistent chronic dacryocystitis 7 eyes(5.6%), nasal mucosal granulation 6 eyes(4.8%), septal touch by tube 6 eyes(4.8%), conjunctival granulation 3 eyes (2.4%), and tube extrusion to the conjunctiva 2 eyes (1.6%). However no clinically significant complication developed postoperatively. The above procedure has many advantage such as no operations scar, short operation time, no need of expensive instruments and simple procedure. Therefore, this procedure seems to be of value in treatment of obstruction of lacrimal apparatus.