A single case report of different types of Jones Tubes used on the same person to resolve longstanding nasolacrimal duct obstruction with a previous history of multiple failed surgeries
Author: Anna Gkountelia
Base Hospital / Institution: BHRUT, Queen’s Hospital, Romford, UK
ePoster presentation
Abstract ID: 24-166
Purpose
To present a case of bilateral nasolacrimal duct obstruction (NLDO) with multiple previous surgeries abroad since childhood, whose epiphora improved with a Lester Jones tube (LJT) in one eye and a StopLoss Jones tube (SLJT) in the other eye.
Methods
A case report of a single case at our district general hospital eye department in Greater London, United Kingdom
Results
A 50-year-old female was referred into our adnexal clinic 6 months post- bilateral endoscopic dacryocystorhinostomy (DCR) done abroad. She had a long history of bilateral NLDO with multiple repeat nasolacrimal and rhinal surgery. Bilateral stents were seen (present for 6 months) and removed after causing local irritation. She developed repeat epiphora and lacrimal syringing showed complete obstruction of both superior and inferior canaliculi. CT orbit/sinuses showed chronic rhinosinusitis and fracture/loss of anteromedial orbital walls bilaterally secondary to surgery. Endoscopic NLD exploration showed scarred tissue and distorted anatomy. It was not possible to place further stents. We subsequently inserted bilateral LJTs. Post-operatively, the right LJT was misplaced and causing conjunctival irritation. We replaced the LJT with a SLJT. Postoperatively, the patient has remained asymptomatic for 5 months and reports no difference between the two eyes
Conclusion
In a patient with multiple failed DCR surgery for NLDO, LJT can be an effective solution. In such cases, both eyes may behave differently and require different approach and careful selection of JT types.
In this single case report, we had the opportunity to observe different types of JT used on the same person. No significant difference has been observed between both sides clinically neither from the patient’s perspective 6 months postoperatively.
Based on previous studies, satisfaction with LJT insertion is high. The internal silicone flange on the SLJT reduces extrusion seen with LJT and is an important alternative. We will keep observing this single case long-term and present our findings if they are of interest.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Wessam | Mina | BHRUT, Queen’s Hospital, Romford, UK |
