J Korean Ophthalmol Soc.  2008 Oct;49(10):1553-1558.

Purse-string Suture Technique for Jones Tube Fixation in Conjunctivodacryocystorhinostomy

• Lee TS
• Lee H

Abstract

PURPOSE
To evaluate the usefulness of Jones tube fixation using a purse-string suture, and to minimize postoperative conjunctival incarceration into the collar opening of the tube and extrusion or intrusion of the tube in the early postoperative period.
METHODS
Thirty-five conjunctivodacryocystorhinostomy (CDCR) with tube fixation by purse-string suture were performed over the period of 1 year with a mean follow-up of 8.3 months. At the end of endoscopic CDCR procedure, to secure the tube in both the surrounding conjunctiva and tissues in the canthus, a 5-0 Vicryl suture was passed through the conjunctiva and Tenon's capsule just lateral to the collar of the tube and then tied around the collar of the tube in the fashion of a purse string. Finally, it was externalized to the skin of the canthal area where it was fixed. The suture was left alone if it did not cause problems postoperatively.
RESULTS
Of 35 cases, there were no cases of intrusion of the tube or clogging of the tube with the conjunctiva at 6 months postoperatively. Partially extrusion was found in only two cases at 6 and 9 months postoperatively. One case of inadvertent tube retrieval was noted while irrigating the tube at postoperative 1 month.
CONCLUSIONS
This procedure is a simple and superior way of fixing a Jones tube to maintain tube position during the early postoperative period.

Keyword

Epiphora; Punctal obstruction; Punctoplasty; Silicone tube intubation

MeSH Terms

Conjunctiva
Follow-Up Studies
Lacrimal Apparatus Diseases
Polyglactin 910
Postoperative Period
Skin
Suture Techniques
Sutures
Tenon Capsule
Polyglactin 910

Figure

• 

  Figure 1. (A) A double-armed 5-0 Vicryl suture was passed through the conjunctiva and Tenon’s capsule just lateral to the collar of the tube, which was repeated with 3 bites. (B) Each arm of the 5-0 Vicryl was tied together around the collar of the tube at the medial side of the tube in the fashion of purse string. (C) Then each arm was externalized to the skin of the canthal area to secure.

Reference

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