Indications and techniques of implantation of hydrophilic lacrimal tubes

In cases of total loss of the lacrimal canalicular system, e.g. due to untreated traumatic laceration, resection of an infiltratively growing malignant tumour of the medial canthus or severe canaliculitis a substitutional surgical procedure using the newly developed hydrophilic lacrimal tube is indicated, as experience with homoplastic material has shown that successful long-term results with homoplastic material (arteries, veins and prepared conjunctival tube) cannot be expected. The advantages of the new material compared to the acrylic tubes of L. T. Jones are the hydrophilic nature and its softness as a result of which no problems with fixation of the tube and pressure necrosis of the medial canthus exist. The implantation is done after performing a conjunctivo-dacryocystotomy or conjunctivo-ductostomy. In cases of conjunctivo-dacryocystotomy the tube may be removed after 1 to 1 1/2 years.