[The clinical study of lacrimal bypass surgery with high-density porous polyethylene coated tear drain implantation].
OBJECTIVE
To analyze the outcomes of lacrimal bypass surgery using the high-density porous polyethylene (HDPP) coated tear drain and to evaluate the validity and safety of this procedure.


METHODS
Twenty-six patients (26 eyes) with severe epiphora who could not be cured by canaliculo-anastomosis and dacryocystorhinostomy were treated by the lacrimal bypass surgery with the HDPP coated tear drain. HDPP tube insertion: 10 patients with defect of the punctum or the canaliculi and in the presence of lacrimal sac were treated by conjunctiva-dacryocystorhinostomy with HDPP coated tear drain implantation. 16 patients with defect of the punctum or the canaliculi and without lacrimal sac were treated by simple HDPP coated tear drain insertion.


RESULTS
No tube extrusion or severe malposition occurred after 4 - 28 months follow-up. Complete or significant improvement of epiphora was achieved in 88.5% cases. Most patients (80.8%) satisfied with the therapeutic result of this procedure. Complications included obstruction (9 eyes), discomfort (4 eyes), improper tube length (2 eyes), malposition (1 eye), infection (1 eye), diplopia (1 eye), abrasion of cornea (1 eye) and nasal secretion countercurrent (1 eye).


CONCLUSIONS
The lacrimal bypass surgery with the HDPP coated tear drain could be expected to improve epiphora significantly in most cases of lacrimal obstruction. This surgery has a higher successful rate and fewer complications than that of Jones tube insertion and is a safe and efficient procedure.
Fan
Xian-qun
XQ
Department of Ophthalmology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200011, China. fanxq@sh163.net
Bi
Xiao-ping
XP
Fu
Yao
Y
Zhou
Hui-fang
HF
D000293:Adolescent; D000328:Adult; D003608:Dacryocystorhinostomy / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020959:Polyethylene; D019919:Prosthesis Implantation; D055815:Young Adult
D020959:Polyethylene