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Abstract ID: 24-125
Long-term Outcomes of Conjunctivodacryocystorhinostomy with Lester Jones Tubes
Ekaterina Kondratishko
Purpose
Nasolacrimal duct obstruction (NLDO) frequently leads to epiphora, or excessive watering of the eyes, and is classified into distal and proximal types based on the site of obstruction. Proximal NLDO is often managed with punctal/canalicular ballooning, stenting, or punctoplasty, but may require conjunctivodacryocystorhinostomy (CDCR) if these above-mentioned treatments prove ineffective. This study evaluates the long-term outcomes of CDCR using StopLoss®️ Jones tubes in adults with proximal NLDO.
Methods
Seven adult patients, encompassing a total of nine eyes, were treated between 2018 and 2023 by the same surgical team at a Riga Medical Center. All patients, diagnosed with proximal NLDO at the canaliculi level, were unsuitable for less invasive treatments. Diagnostic CT scans of paranasal sinuses were performed pre-operatively to identify individual anatomical landmarks to facilitate intraoperative navigation. StopLoss® Jones tubes were utilised in all cases.
Results
Six of the seven patients demonstrated satisfactory long-term results with complete cessation of excessive tearing and reported desirable cosmetic outcomes. However, one patient experienced recurrent dislocation of the Jones tube and subsequent obstruction due to a history of eyelid retraction following blepharoplasty, which presented challenges during tube extraction.
Conclusion
CDCR with StopLoss® Jones tube insertion emerges as a safe and effective treatment for proximal NLDO. Nonetheless, further guidance is necessary concerning patient follow-up, particularly for individuals at risk of tube displacement. Additionally, protocols for safety-netting and patient education regarding when to seek medical attention in case of complications are essential aspects to consider for optimising patient care and outcomes.
Additional Authors
Anna Kremneva – Riga Stradiņš University
Irina Kornilova – Riga Stradiņš University
Aleksejs Derovs – Riga Stradiņš University
Ģirts Briģis – Riga Stradiņš University