Long-term follow-up of Conjunctivodacryocystorhinostomy

Yun, Jae Rak; Chang, Han Ki

Abstract

Conjunctivodacryocystorhinostomy(CDCR) with a Pyrex tube is an accepted procedure for the treatment of epiphora resulting from obstructed canaliculi. We analyzed the success rate, complications and it's treatment of 181 eyes who underwent CDCR with a Pyrex tube at Wallace Memorial Baptist Hospital between september 1986 and march 1996. Straight tubes, 18mm long(70 of 181 eyes; 38.7%) was most commonly used. Of 181 eyes, 172 eyes(95%) were successful. Complications of CDCR included submergence of Pyrex tube (13 of 181 eyes; 7.2%), tube extrusion(9 of 181 eyes; 4.9%), tube extraction(5 of 181 eyes; 8.9%). Of the 9 eyes of tube extraction, 7 eyes were 20mm in length, and the exchange of 20mm for 18mm was performed under topical anesthesia and two eyes, 18mm in length were replaced by 16mm in length. It was successful in 3 eyes but 6 eyes were dissatisfied because of residual tearing. In 13 eyes of tube submergence, tubes were sutured with 5-0 nylon to the skin of medial canthus and was successful in 10 eyes but was failed in 3 eyes. Of 181 eyes, 5 eyes(2.8%) lost their tube. 4 patients came for treatment 24 hours after tube loss and 1 patients came for treatment 72 hours after tube loss. A simple tube reinsertion was successful in all cases. Other complications were granuloma formation(16 of 181 eyes; 8.8%), conjunctival growth over the tube opening(8 of 181 eyes; 4.4%) and infection (5 of 181 eyes; 2.8%). Granuloma recurred two times in 4 eyes, three times in 2 eyes, four times in 1 eyes and was resected effectively each time under topical anesthesia. Conjunctival overgrowth was treated with conjunctival resection and tube manipulation. The infection resolved completely on consecutive treatment with topical and oral antibiotics.