Conjunctivodacryocystorhinostomy - experience of a Tertiary Hospital
DOI:
https://doi.org/10.34631/sporl.3113Keywords:
lacrimal drainage obstruction, epiphora, conjunctivodacryocystorhinostomy, Jones Stop Loss tubeAbstract
Introduction: Conjunctivodacryocystorhinostomy (CDCR) is primarily indicated for proximal lacrimal obstruction, as well as in trauma or persistent epiphora after DCR.Objective: To review the clinical indications for CDCR, describe the surgical technique, and outline the challenges encountered.
Materials and Methods: Retrospective series of patients undergoing CDCR with Jones Stop Loss Jones Tubes (SLJT) tubes. Anatomical success was defined by tube patency on irrigation, and functional success by resolution of epiphora.
Results: Five CDCR procedures were performed. Etiologies included congenital lacrimal system agenesis, failed DCR, and iatrogenic lacrimal canal stenosis.
Conclusion: CDCR with SLJT tubes is a surgical option to consider in cases of proximal obstruction and failed conventional DCR, with endoscopic technique being essential for accurate tube placement. Complications such as inferior tube migration and conjunctival overgrowth remain challenging, requiring long-term follow-up.
Downloads
References
Eisenbach N, Karni O, Sela E, Nemet A, Dror A, Levy E. et al. Conjunctivodacryocystorhinostomy (CDCR) success rates and complications in endoscopic vs non-endoscopic approaches: a systematic review. Int Forum Allergy Rhinol. 2021 Feb;11(2):174-194. doi: 10.1002/alr.22668.
Nowak R, Rekas M, Ali MJ. Long-term outcomes of StopLoss™ Jones tube (SLJT) and minimally invasive conjunctivodacryocystorhinostomy. Graefes Arch Clin Exp Ophthalmol. 2022 Jan;260(1):327-333. doi: 10.1007/s00417-021-05347-1.
Guo Y, Rokohl AC, Kroth K, Li S, Lin M, Jia R. et al. Endoscopy-guided diode laser-assisted transcaruncular StopLoss Jones tube implantation for canalicular obstructions in primary surgery. Graefes Arch Clin Exp Ophthalmol. 2020 Dec;258(12):2809-2817. doi: 10.1007/s00417-020-04942-y.
Jones LT. Conjunctivodacryocystorhinostomy. Am J Ophthalmol. 2018 Mar:187:xxxvi-xliv. doi: 10.1016/j.ajo.2018.02.004.
Athanasiov PA, Madge S, Kakizaki H, Selva D. A review of bypass tubes for proximal lacrimal drainage obstruction. Surv Ophthalmol. 2011 May-Jun;56(3):252-66. doi: 10.1016/j.survophthal.2011.02.009.
Lim C, Martin P, Benger R, Kourt G, Ghabrial R. Lacrimal canalicular bypass surgery with the Lester Jones tube. Am J Ophthalmol. 2004 Jan;137(1):101-8. doi: 10.1016/j.ajo.2003.08.002.
Na J, Lee S, Park J, Lee H, Baek S. Surgical outcomes of endonasal conjunctivodacryocystorhinostomy according to Jones Tube location. J Craniofac Surg. 2017 Jul;28(5):e500-e503. doi: 10.1097/SCS.0000000000003801.
Woog JJ, Sindwani R. Endoscopic dacryocystorhinostomy and conjunctivodacryocystorhinostomy. Otolaryngol Clin North Am. 2006 Oct;39(5):1001-17, vii. doi: 10.1016/j.otc.2006.08.005.
Nowak R. Management of inferior dislocation of a StopLoss Jones tube after conjunctivodacryocystorhinostomy. BMJ Case Rep. 2020 Nov 9;13(11):e236003. doi: 10.1136/bcr-2020-236003.
Choi WC, Yang SW. Endoscopy-guided transcaruncular Jones tube intubation without dacryocystorhinostomy. Jpn J Ophthalmol. 2006 Mar-Apr;50(2):141-6. doi: 10.1007/s10384-005-0284-y.
Nowak R, Rekas M, Ali MJ. Long-term quality of life in patients following minimally invasive conjunctivodacryocystorhinostomy with StopLoss Jones tube. Ophthalmic Plast Reconstr Surg. 2022 Mar-Apr;38(2):170-175. doi: 10.1097/IOP.0000000000002017.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Joana Guincho, Luís Baptista, Carlota Sousa, Rui Cabral, Filipe Correia, Pedro Branco, Gustavo Almeida, Nelson Gilberto, Pedro Escada
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
