J Korean Ophthalmol Soc.  2019 Dec;60(12):1121-1127. 10.3341/jkos.2019.60.12.1121.

A Retrospective Review of Endoscopic Conjunctivodacryocystorhinostomy Reoperation Cases

• Woo M
• Yang S
• Park J
• Lee H
• Baek S

• KMID: 2466160
• DOI: http://doi.org/10.3341/jkos.2019.60.12.1121

Abstract

PURPOSE
To analyze the causes, success rate, and the changes of Jones tube length in endoscopic conjunctivodacryocystorhinostomy (CDCR) reoperation cases.
METHODS
The medical records of 40 patients (41 eyes, a total of 52 cases) who underwent reoperation of CDCR with Jones tube reinsertion using an endoscope from January 2013 to December 2018 were retrospectively reviewed. We analyzed the success rate, causes of reoperation, changes in lengths of used tubes, and the average interval times between operations.
RESULTS
The most common cause of reoperation was medial tube migration (53.8%). As in other causes, tube loss (17.3%), obstructions related with conjunctival overgrowth or granulation (13.46%), lateral tube migration (11.53%), iatrogenic removal (1.92%), and acute dacryocystitis (1.92%) followed. In patients with medial tube migration, the average tube length used in reoperations decreased by approximately 1.11 mm compared to prior operations. In cases of lateral tube migration, the average tube length increased approximately 1.00 mm after the reoperation. The success rate of reoperations was 78.04%. The average interval time between the initial operation and the first reoperation was 52 months. In cases with several reoperations, the interval time decreased as the number of reoperations increased.
CONCLUSIONS
Because medial tube migration was found to be the most common cause of reoperations, it should be considered as a potential problem when performing surgery. The changes in the lengths of inserted Jones tubes were related to certain types of complication, which affected the prognoses. In endoscopic CDCR reoperations, the success rate was favorable. In recurrent cases, the average interval time between reoperations decreased as the number of operations increased.

Keyword

Complications; Conjunctivodacryocystorhinostomy; Endoscopic; Jones tube; Re-operation

MeSH Terms

Dacryocystitis
Endoscopes
Humans
Medical Records
Prognosis
Reoperation*
Retrospective Studies*

Figure

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  Figure 1. Cases of complications leading to reoperations. (A) A case of medial migration of Jones tube. Because of the migration, the end of Jones tube was not observed (arrow). (B) A case of lateral migration of Jones tube. The end of the tube is protruded (arrow). (C) Granulomatous obstruction of Jones tube is seen (arrow).

Reference

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