title: A new lacrimal bypass tube fixation method to prevent tube displacement in conjunctivodacryocystorhinostomy (CDCR).
abstract: OBJECTIVE
  To evaluate the efficacy of a new lacrimal bypass tube fixation technique to the conjunctiva and caruncle, preventing postoperative displacement of the tube in conjunctivodacryocystorhinostomies (CDCRs).
  
  
  METHODS
  The authors conducted 52 CDCR procedures by a new tube fixation technique using a 6-0 prolene suture encircling the tube neck (encircling group). The suture was not removed during the follow-up period. Over the same period, the authors carried out 51 CDCRs with tube fixation using a 5-0 vicryl suture with the purse string procedure (purse string group) and 71 conventional CDCRs with tube fixation to the skin using a 6-0 nylon suture (control group). Postoperative complications, including dislodgement and tube length problems, were recorded. The three groups were statistically compared.
  
  
  RESULTS
  Among the 52 cases using the new fixation technique, tube malpositions, including extrusions, had developed in only four cases (7.7%) at 12 months after the operation. In the purse string and control groups, the same complications developed in 11 (21.6%) and 22 cases (31.0%), respectively. A statistically significant difference between these groups was detected (p=0.008). Other complications, such as conjunctival granulomas and tube obstruction, developed postoperatively in four cases (8.0%) in the encircling group, and this did not differ significantly from that in the other groups (p=0.193).
  
  
  CONCLUSIONS
  The authors believe that this encircling fixation procedure can help in CDCRs for maintaining the location and orientation of the tube during the early postoperative period.
authors.affiliation: Department of Ophthalmology, Guro Hospital, Korea University College of Medicine, 97 Gurodong-gil, Guro-gu, Seoul 152-703, Korea.
authors.forename: Minwook
authors.initials: M
authors.lastname: Chang
authors.forename: Sehyun
authors.initials: S
authors.lastname: Baek
authors.forename: Tae Soo
authors.initials: TS
authors.lastname: Lee
mesh_terms: D003228:Conjunctiva / Q000601:surgery*; D003608:Dacryocystorhinostomy / Q000379:methods*; D005260:Female; D005548:Foreign-Body Migration / Q000517:prevention & control*; D005898:Glass; D006801:Humans; D007440:Intubation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000601:surgery; D009757:Nylons; D011098:Polyglactin 910; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D013536:Suture Techniques; D013537:Sutures; D016896:Treatment Outcome
chemical_list: D009757:Nylons; D011098:Polyglactin 910