|Year : 1979 | Volume
| Issue : 4 | Page : 218-219
Dachryocystorhinostomy with introduction of polythene tube through both canaliculi
Subhash A Gokhale
LTMG Hospital, Sion, Mumbai, India
Subhash A Gokhale
LTMG Hospital, Sion, Mumbai
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Gokhale SA. Dachryocystorhinostomy with introduction of polythene tube through both canaliculi. Indian J Ophthalmol 1979;27:218-9
|How to cite this URL:|
Gokhale SA. Dachryocystorhinostomy with introduction of polythene tube through both canaliculi. Indian J Ophthalmol [serial online] 1979 [cited 2019 Oct 19];27:218-9. Available from: http://www.ijo.in/text.asp?1979/27/4/218/32637
Temporary insertion of a polythene tube is required during dachryocystorhinostomy (D.C.R.) in some cases.
In the usual technique, the tube is passed through the lower punctum, lower canaliculus, D.C.R. ostium, nasal cavity and finally the two ends are tied together on the cheek. The disadvantage of this method is that the tube cannot be kept for more than a few weeks because of the bad cosmetic appearance and the difficulty in washing the face. Removal of the tube after a few weeks is many times followed by a gradual block as complete epithelialisstion does not occur in that period.
Werb reported by Griffith, first introduced the technique of introducing one end of a polythene tube through the upper punctum and the other end through the lower punctum, both the ends being kept in the nasal cavity.
This is a report of 25 such operations done
in the last 6 years. The indications were:
1. Blokage of common canaliculus-16 cases
2. Dacryocystectomy already done -5 cases
3. Flaps could not be sutured properly because of profuse bleeding -3 cases
4. Accidental injury to the opening of the common canaliculus 1 case
Total-- 25 cases
At first the patient complains of epiphora as the canaliculi are blocked by the polythene tube. The tube is used here like a solid cord and its lumen is not used for drainage. Gradually a channel forms around the tube and the watering stops. This takes about 6 months to one year. When watering stops completely the tube is removed by cutting the loops between the two puncti and pulling the two ends from the nasal cavity. The sleeve of the thicker tube also comes out as it is snugly fitting over the smaller tube. The patient also complains of foreign body sensation in the nasal cavity because of the two ends of the polythene tube, but it disappears within a few days.
The tension in the loop which passes from the upper to lower punctum can be adjusted at any time by moving the sleeve of the thicker tube towards or away from the common canaliculus, using a nasal forceps passing through the nasal cavity under local anaesthesia.
There was no recurrence of epiphora in any case: Complications: These occured only in the beginning of the series.
(1) One patient complained of diplopia due to the loop of polythene tube pressing on the medial aspect of the eye ball. This could be corrected by adjusting the tension in the loop by moving the sleeve of thicker tube.
(2) In one case there was profuse postoperative bleeding from the nose probably because of injury to mucosa over the nasal septum while passing a sharp needle forcibly through the common canaliculus after suturing the posterior flaps of sac and nasal mucosa. It could be stopped by packing the nasal cavity.
(3) In one case the tube cut through the canaliculi after 3 months but there was no epiphora after removal of the tube.
| References|| |
|1.|Griffith, T.P., 1963, British J. Ophthal., 47, 203.