Jones' lacrimal canalicular bypass tubes: twenty-five years' experience

The results after implantation of Lester Jones canalicular bypass tubes in 326 eyes (310 patients) are reviewed. The bypass tubes were implanted after canalicular obstruction from a variety of causes, of which post-herpetic or post-traumatic obstruction accounted for one-half of all cases. With up to 23 years' follow-up, replacement of the bypass tube was needed in 142 (44%) patients, the majority after spontaneous loss. The median interval to first replacement may be estimated as about ten years for spontaneous loss and five years for all causes. Despite complications and the need for further surgery in many patients, most patients (91%) were pleased with the functional result of surgery. The principles, techniques and complications of lacrimal canalicular bypass surgery are presented and the long-term care of bypass prostheses is discussed.