The treatment of lacrimal apparatus obstruction with the use of an inner canthal Jones tube insertion via a transcaruncular route

BACKGROUND AND OBJECTIVE: To evaluate the clinical utility of the lacrimal bypass surgery using Bowman's probe in treatment of obstruction of the lacrimal apparatus. PATIENTS AND METHODS: This study evaluated 124 cases of obstruction of the lacrimal passage systems with mean epiphora of 2.7 years. An incision was made on the side of the caruncle, and the lacrimal bone was penetrated between the lacrimal sac and the nasal mucosa by Bowman #0. Insertion of a Jones tube was made at the new lacrimal pathway, a puctum dilator or scissors was introduced through the caruncle and dilated across the lacrimal bone into the nasal cavity. The Jones tube was introduced over the probe into the nasal cavity, and fixed at the caruncle with nonabsorbable suture material. RESULTS: Complete resolution of epiphora was accomplished in 120 (96.8%) of 124 eyes; only 4 (3.2%) eyes failed during a mean of 17.1 months of follow-up. CONCLUSION: This procedure is simple and safe with no facial scarring, short operation time, high success rate, and can be performed under local anesthesia. Therefore, the clinical utility of this procedure seems to be of value in treatment of complicated obstruction of the lacrimal apparatus.