Department of Ophthalmology, Jozef Strus City Hospital, Poznan, Poland.
Department of Ophthalmology, Military Institute of Medicine, Warsaw, Poland.
Graefes Arch Clin Exp Ophthalmol. 2022 Jan;260(1):327-333. doi: 10.1007/s00417-021-05347-1. Epub 2021 Aug 12.
To assess the long-term outcomes of minimally invasive conjunctivodacryocystorhinostomy (MICDCR) with StopLoss™ Jones tubes.
A retrospective interventional case series was performed on all patients who underwent a MICDCR with StopLoss™ Jones tubes (SLJT) over a period of 5 years. Patients were followed for a minimum of 1 year after surgery. The parameters studied include patient demographics, clinical presentation, indication for MICDCR, duration of surgery, SLJT length, standard Jones tube drainage classification, complications, and anatomical and functional successes. The variables influencing the outcomes were assessed. Anatomical success was defined as patent SLJT on irrigation, and functional success was defined as resolution of epiphora. Statistical analysis was performed using the R 4.0.4 (R Project, R Foundation).
A total number of 44 eyes of 42 patients were studied. The mean age of patients was 61.81 years. Approximately 87% and 64% of the patients completed 2 years and 3 years of follow-up, respectively. The Jones tube drainage class dipped significantly from class I to others at the 3-month follow-up. Classes III and IV dominated the follow-up period between 3 and 18 months, and class II dominated at 24 months and beyond. The anatomical and functional successes at the end of 1-year follow-up were 77.2%. The success was not affected by age, gender, length of SLJT tube, or duration of the surgery. However, the middle turbinate reduction influenced the success (P < 0.03). The common complications noted were tube occlusions (40.9%, 18/44) and inferior tube migration (38.6%, 17/44).
The long-term outcomes with SLJT were good, but the inferior migration was a significant complication. The results of this study reflect the need for continuity of care as long as the tube is in situ.
评估微创经结膜鼻腔泪囊吻合术（MICDCR）联合 StopLoss™Jones 管的长期疗效。
对 5 年内接受 MICDCR 联合 StopLoss™Jones 管（SLJT）治疗的所有患者进行回顾性介入病例系列研究。患者术后随访至少 1 年。研究的参数包括患者人口统计学、临床表现、MICDCR 适应证、手术时间、SLJT 长度、标准 Jones 管引流分类、并发症以及解剖学和功能成功。评估了影响结果的变量。解剖学成功定义为冲洗时 SLJT 通畅，功能成功定义为溢泪缓解。使用 R 4.0.4（R 项目，R 基金会）进行统计学分析。
共纳入 42 例患者的 44 只眼。患者的平均年龄为 61.81 岁。约 87%和 64%的患者分别完成了 2 年和 3 年的随访。在 3 个月的随访时，Jones 管引流等级从 I 级显著降至其他等级。在 3 至 18 个月期间，III 级和 IV 级占主导地位，在 24 个月及以后，II 级占主导地位。在 1 年随访结束时，解剖学和功能成功率为 77.2%。年龄、性别、SLJT 管长度或手术时间均不影响成功率。然而，中鼻甲缩小会影响成功率（P<0.03）。常见的并发症包括管堵塞（40.9%，18/44）和管下迁移（38.6%，17/44）。
SLJT 的长期疗效良好，但下迁移是一个显著的并发症。本研究结果反映了只要管子在位，就需要持续护理。
