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      Comparison of Medpor Coated Tear Drainage Tube versus Silicon Tear Drainage Tube in Conjunctivodacryocystorhinostomy: Problems and Solutions

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          Abstract

          Purpose. This study aims at comparing two different types of drainage tubes in conjunctivodacryocystorhinostomy, which are used for upper lacrimal system obstruction or damage, with respect to their respective postoperative problems and solutions. Methods. Nineteen eyes of 17 patients who underwent conjunctivodacryocystorhinostomy (CDCR) or conjunctivorhinostomy (CR) surgery with a Medpor coated tear drainage tube or silicon tube placement between October, 2010, and February, 2014, were included in this retrospective comparative study. Results. In the initial surgery, Medpor coated tear drainage tubes were used in 11 eyes by CDCR, whereas silicon tear drainage tubes were implanted into 2 eyes by CR and 6 eyes by CDCR. In group 1, proximal and distal obstructions developed postoperatively in 4 eyes, while 1 eye showed tube malposition and 3 eyes developed luminal obstruction by debris 3 times. In group 2, tube extrusion developed in 4 eyes, whereas tube malposition developed in 6 eyes and luminal obstruction by debris developed in 6 eyes at different times, for a total of 20 times. Conclusions. In our study, the most significant complication we observed in the use of silicon tear drainage tubes was tube extrusion,whereas the leading complication related to the use of Medpor coated tear drainage tubes was tube obstruction.

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          Most cited references28

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          Patient dissatisfaction after functionally successful conjunctivodacryocystorhinostomy with Jones tube.

          Conjunctivodacryocystorhinostomy with a Jones tube is an accepted procedure for the treatment of epiphora resulting from obstructed canaliculi. Because of our clinical impression that a high rate of functional success after surgery is associated with a lower rate of patient satisfaction, we analyzed the results and patient satisfaction of 121 patients who underwent conjunctivodacryocystorhinostomy with Jones tubes. The surgical success rate was 92.6% (112 of 121 patients). However, 13 of 112 patients (11.6%) whose operation was functionally successful were not satisfied and 36 of 112 patients (32%) reported having more complications than expected. The highest rate of dissatisfied patients occurred in patients 70 years of age or older (ten of 46 patients, 22%) and in patients 19 years of age or younger (one of four patients). Thus, the indication for conjunctivodacryocystorhinostomy in these age groups should be limited to exceptionally remarkable symptomatic cases. The drawbacks of the procedure should be explained to all candidates to minimize dissatisfaction resulting from unrealistic expectations.
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            Problems associated with conjunctivodacryocystorhinostomy.

            Fifty-eight patients (69 eyes) underwent conjunctivodacryocystorhinostomy for lacrimal canalicular obstruction. The cause of lacrimal obstruction and the results and complications of the operation were analyzed. Trauma and idiopathic disease were the most common causes of lacrimal canalicular obstruction in 24 of 69 (34.8%) eyes each. Relief of epiphora was achieved in 68 of the 69 eyes (98.5%). The complications included tube displacement in 40 of the 69 eyes (57.9%), tube obstruction in 19 of the 69 eyes (27.5%), and infection of the lacrimal sac in four of the 69 eyes (5.8%). Despite frequent complications, most Jones tubes can be made to function satisfactorily. Conjunctivodacryocystorhinostomy remains the best surgical treatment at this time for permanent loss of canalicular function.
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              The cure of epiphora due to canalicular disorders, trauma and surgical failures on the lacrimal passages.

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                Author and article information

                Journal
                ScientificWorldJournal
                ScientificWorldJournal
                TSWJ
                The Scientific World Journal
                Hindawi Publishing Corporation
                2356-6140
                1537-744X
                2014
                14 October 2014
                : 2014
                : 164834
                Affiliations
                1Department of Ophthalmology, Sisli Etfal Training and Research Hospital, Halaskargazi Street, Etfal Home Street, Şişli, 34371 Istanbul, Turkey
                2Department of Ophthalmology, Faculty of Medicine, Kafkas University, Pasacayiri Street, 36301 Kars, Turkey
                Author notes
                *Selam Yekta Sendul: sysendul@ 123456hotmail.com

                Academic Editor: Ji Eun Lee

                Article
                10.1155/2014/164834
                4212598
                25379518
                80069e49-af6c-4904-bcdd-9aed0c94d536
                Copyright © 2014 Selam Yekta Sendul et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 5 July 2014
                : 21 August 2014
                Categories
                Clinical Study

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