Long-Term Outcomes of StopLoss Jones Tubes for Epiphora in Patients With Early or Multiple Loss of Lester Jones Tubes. Issue 2 (March 2020)

• Record Type: Journal Article
• Authors: Timlin, Hannah M.; Jiang, Kailun; Mathewson, Priscilla; Manta, Alexandra; Rubinstein, Tal; Ezra, Daniel G.
• Is Part Of: Ophthalmic plastic and reconstructive surgery. Volume 36:Issue 2(2020)
• Publication Date: 2020-03
• Subjects: Eye -- Surgery -- Periodicals; Ophthalmic plastic surgery -- Periodicals; Reconstructive Surgical Procedures -- Periodicals; Ophthalmologic Surgical Procedures -- Periodicals; Ophthalmology -- Periodicals; Surgery -- Periodicals; 617.70592
• DOI: 10.1097/IOP.0000000000001479
• Languages: English
• ISSNs: 0740-9303

Abstract

Abstract : Purpose: Extrusion is the most common cause of failure in conventional Lester Jones tubes (LJTs). StopLoss Jones tubes (SLJTs) with distal flange are designed to reduce this complication. This study compared the survival of SLJTs with their prior LJTs and control patients with LJTs-only. Methods: Retrospective review of consecutive LJT or SLJT insertion between January 2014 and December 2016. Results: Twenty-eight eyes of 23 patients had 31 SLJTs. Before their SLJTs, these patients had 116 cumulative failed LJTs. Forty-seven eyes of 34 patients had 59 LJTs only. Fifty-two percent of SLJT group and 18% of LJT-only group had complex medial canthal conditions ( p = 0.003). Compared to their previous LJTs, the SLJTs were less likely to extrude (3% SLJT vs. 64% prior LJT, p < 0.0001); there was no statistical difference in rates of sinking in (26% SLJT vs. 13% prior LJT, p = 0.0964). The median survival of LJTs in those who went on to have a SLJT was 3.5 months. SLJT insertion significantly lengthened the median survival to 26 months ( p < 0.0001), comparable to the LJT-only group (25.5 months, p = 0.45). While extrusion was also the most common complication in the LJT-only group, this occurred only in 20% of eyes; tube failure from sink-in occurred in 14% of eyes. Conclusions: SLJTs, in patients prone to multiple or early prior LJT losses, can be used to rescue this group and allow them to regain a similar survival curve to the less complicated LJT-only group. Rates of tube extrusion are significantly reduced with the use of SLJT. Abstract : SLJTs significantly increased the median survival of conjunctivodacryorhinostomy bypass in those with multiple prior LJT losses. The 2-fold increase in sinking-in rate is outweighed by their 20-fold decrease in extrusion rate.