title: Endoscopic Transretracaruncular-Middle Meteas Tract for Insertion of a Porous Polyethylene-Coated Jones Tube.
abstract: OBJECTIVE
  The purpose of this article is to describe a modified lacrimal bypass with a porous polyethylene-coated Jones tube.
  
  
  METHODS
  A total of 180 patients (180 eyes) with a nonreconstructable lacrimal obstruction underwent lacrimal bypass with a porous polyethylene-coated Jones tube through a retrocaruncular-middle meatus tract approach with endoscopic assistance. All patients were followed up at least for 24 months. Success rate of lacrimal bypass was analyzed and complications were recorded.
  
  
  RESULTS
  A total of 174 patients were finally included. Duration of surgery ranged from 28 to 47 minutes (mean 37.2 ± 4.2 minutes). The mean duration of follow-up was 30.0 ± 6.4 months (range 24-48 months). The mean tube length was 23.2 ± 1.9 mm (range 20-28 mm). At the final review, complete success was achieved in 138 (79.3%) patients. Moderate success was achieved in 23 (13.2%) patients, and 13 (7.5%) patients failed. Of the 161 patients successfully treated, 24 patients underwent revision surgery to excise granulomas (15 patients) or adjust tube position (9 patients). The complications included granuloma proliferation around the openings of the tube (28 eyes), downward displacement of the tube (17 eyes), and ocular discomfort (15 eyes). The majority of downward tube migration occurred in patients who had a prior history of dacryocystorhinostomy. The treatment failed for 5 patients because of repeated granulomas covering the nasal tube openings, and the treatment failed for 8 patients because of downward displacement of the tube.
  
  
  CONCLUSIONS
  Our procedure appears to be an effective method for closed insertion of a porous polyethylene-coated Jones.
authors.affiliation: *The Department of Ophthalmology, Lishui Central Hospital, Lishui †The Eye Hospital of Wenzhou Medical University, Wenzhou, China ‡Discipline of Ophthalmology & Visual Sciences, University of Adelaide and South Australian Institute of Ophthalmology, Adelaide, Australia §Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL.
authors.forename: Songping
authors.initials: S
authors.lastname: Yu
authors.forename: Wentao
authors.initials: W
authors.lastname: Yan
authors.forename: Dinesh
authors.initials: D
authors.lastname: Selva
authors.forename: Zhenbin
authors.initials: Z
authors.lastname: Qian
authors.forename: Michelle
authors.initials: M
authors.lastname: Sun
authors.forename: Pelaez
authors.initials: P
authors.lastname: Daniel
authors.forename: Yunhai
authors.initials: Y
authors.lastname: Tu
authors.forename: Bo
authors.initials: B
authors.lastname: Yu
authors.forename: Wencan
authors.initials: W
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D020099:Coated Materials, Biocompatible; D003608:Dacryocystorhinostomy / Q000379:methods*; D005260:Female; D006801:Humans; D007440:Intubation / Q000295:instrumentation*; D007765:Lacrimal Apparatus / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D009666:Nose; D020959:Polyethylene; D016062:Porosity; D016896:Treatment Outcome
chemical_list: D020099:Coated Materials, Biocompatible; D020959:Polyethylene