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Jones tube insertion in children with canalicular agenesis
1University of Ottawa Eye Institute, Ontario, Canada.
Insights
A simplified Jones tube insertion method effectively manages pediatric patients with canalicular agenesis, offering a potentially useful modification for tear duct obstruction. This technique avoids traditional external dacryocystorhinostomy, simplifying treatment.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Background:
- Punctal and canalicular agenesis presents a challenge in pediatric tear drainage management.
- Traditional surgical approaches like external dacryocystorhinostomy can be complex in children.
Observation:
- Two pediatric cases of symptomatic upper and lower canalicular agenesis were treated with Jones tube insertion.
- The procedure was performed without a standard external dacryocystorhinostomy.
Findings:
- One patient with bilateral agenesis remained asymptomatic for 24 months post-bilateral Jones tube insertion.
- The second patient experienced tube dislodgement at 6 weeks but remained asymptomatic for 16 months after replacement.
Implications:
- Jones tube insertion without external dacryocystorhinostomy may be a simplified and effective technique for pediatric tear duct anomalies.
- This modified approach could improve outcomes and reduce complexity in managing congenital nasolacrimal duct obstruction.
Abstract:
The purpose of this report is to describe a simplified method of Jones tube insertion in the management of pediatric patients with symptomatic upper and lower punctal and canalicular agenesis. A 5-year-old female with bilateral upper and lower canalicular agenesis, and a 4-year-old male with agenesis of the right upper and lower canaliculi, underwent placement of Jones tubes without performing standard external conjunctivodacryocystorhinostomy. The first child requiring bilateral Jones tube insertion has remained asymptomatic for 24 months. The Jones tube dislodged in the second patient 6 weeks postoperatively. The tube was replaced, and the child has been asymptomatic for 16 months. The technique of Jones tube insertion without a previous or concomitant external dacryocystorhinostomy may be a useful modification in the management of pediatric patients with symptomatic upper and lower canalicular agenesis.