The Narrow-Lumen Jones Tube: A Novel Approach to Dry Eye Following Conjunctivodacryocystorhinostomy

Conjunctivodacryocystorhinostomy with placement of a Jones tube (JT) is the gold standard for upper lacrimal system dysfunction. However, traditional JT have been associated with various complications. In their practice, the authors have encountered challenges with postoperative dry eye in a select group of patients, with recurrence of epiphora following tube occlusion, suggesting a need for decreasing the rate of tear drainage while maintaining a patent JT. To address this issue, the senior author (J.D.N.) introduced a modified JT with a narrow lumen (reduced-flow JT) for patients who experience significant dry eye symptoms after placement of a JT. The authors describe 3 patients who experienced improvement in dry eye symptoms after the placement of reduced-flow JT. Accepted for publication March 28, 2018. Previously presented at American Society of Ophthalmic Plastic and Reconstructive Surgery 2017 Fall Meeting. Supported by NIH P30 EY010572 and an unrestricted grant from Research to Prevent Blindness. John Ng is a consultant and shareholder for Bio-Logic Aqua Research, Inc. All other authors have nothing to disclose. Address correspondence and reprint requests to John D. Ng, M.D., M.S., F.A.C.S., Casey Eye Institute, Oregon Health and Science University, 3375 SW Terwilliger Blvd, Portland, OR 97239. E-mail: ngj@ohsu.edu © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.