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Bryce Radmall, Eric Ahn, Eric Steele, Roger Dailey; Outcomes of revision conjunctivodacryocystorhinostomy with Jones tubes.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):692.
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© ARVO (1962-2015); The Authors (2016-present)
Determine the success rate of revision conjunctivodacryocystorhinostomy (CDCR) with Jones tubes (JT).
A retrospective chart review was performed identifying those undergoing external and endoscopic CDCR from January 1, 2006 to November 1, 2014. Only those patients having revision CDCR (a patient’s second CDCR), and at least six months follow up were included. The primary outcomes were time to failure of revision CDCRs and the number of subsequent repeat CDCRs needed.
A total of 18 eyes from 16 patients met the inclusion criteria. Average patient age was 57.7 years, with nine females and seven males all of whom were Caucasian. There were nine frosted and nine non-frosted JTs placed at the time of each eye’s initial CDCR. 8/9 frosted JTs either migrated in too deeply or were lost in the nose by history. 5/9 non-frosted JTs were lost having completely migrated out, with the remaining 4/9 migrating too deep to replace. Revision CDCR involved the use of fifteen frosted JTs and three non-frosted JTs, with nine patients requiring lysis of scar tissue involving the nasal ostium, three patients needing changes to the trajectory of the CDCR tract, and eight requiring subtotal middle turbinectomy. Six eyes required further CDCR, four requiring one more CDCR and two each requiring three more CDCRs. Average time from revision CDCR to repeat CDCR was 1604.8 (343-4773) days. Kaplan Meier analysis showed 50% of revision CDCR functioning at 10 years postoperatively.
Most patients undergoing revision CDCR required no further surgery, although 33% needed at least one or more additional CDCRs and this group as a whole over time may have a higher rate of reoperation.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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