Treatment of Obstruction

Traditional Surgical Treatments

Since its introduction in the early years of this century, Incisional dacryocystorhinostomy (DCR) has been the "traditional" procedure most often relied upon for relief of epiphora (chronic tearing) and nasolacrimal duct obstruction in adults. However, the high success rate (> 90%) for incisional DCR is balanced by a number of potential drawbacks:

Dacryocystorhinostomy (DCR)

Create Ostium

Create Ostium

Probe / Intubate

Probe / Intubate
Probe / Intubate
  • The photograph to the right is immediately after surgery.
  • Note that the typical skin incision is quite small, often follows the curve, and is closed with skin sutures.
3 weeks after left DCR, incision is barely noticeable
STEP 1:

The LacriCATH ® balloon catheter (shown in the picture) is inserted through an opening in the corner of the eye and down into the tear duct .® balloon catheter (shown in the picture) is inserted through an opening in the corner of the eye and down into the tear duct .balloon catheter (shown in the picture) is inserted through an opening in the corner of the eye and down into the tear duct .

Step 1  - Pediatric LacriCath
 
STEP 2:

The balloon catheter is inflated with sterile water to dilate the tear duct for a period of 90 seconds. It is then deflated, and reinflated for 60 seconds.

Step 2  - Pediatric LacriCath
 
STEP 3:

The balloon catheter is then repositioned slightly higher in the duct and inflated twice as in step 2.

Step 3 - Pediatric LacriCath

The balloon catheter is then deflated and removed.

Here you can see the balloon as it is inflated within the nose Here you can see the balloon as it is inflated within the nose
Here you can see the balloon as it is inflated within the nose

Movies of Surgical Lacrimal Duct Procedures

 

Lacrimal Stents 

 

CDCR / JONES tube / PG tube

If the "tear duct" obstruction is beyond repair, It might possibly be necessary to surgically implant an artificial "tear duct" behind the inner corner of the eyelids to drain the tears into the nose. The artificial "tear duct" is made of Pyrex glass and is called a "Jones tube." or Putterman-Gladstone (PG) tube.

CDCR / JONES tube / PG tube

These might possibly be purchased at Gunther Weiss Glass Science, located in Portland Oregon. 503-644-3507

Dacryocystorhinostomy surgery provides relief to millions of people every year who suffer from tear duct problems ranging from collapsed tear ducts and excessive tearing caused by accident or injury, birth defects or environmental strain. Left untreated, patients might possibly experience swelling, infections, increased swelling, tearing ("wet eye") and severe pain.

In 1961, Lester T. Jones and Gunther Weiss paired up to develop a solution for tear duct problems. They developed highly specialized glass tubes (called "Lester T. Jones Tear Duct Tubes") designed for insertion into the nasolacrimal duct. The body develops scar tissue around the tube, which holds it in place, forming a new permanent tear duct.

Gunther Weiss Scientific Glass Blowing Company offers Lester T. Jones Tear Duct Tubes in a variety of lengths and diameters to address most patient needs. In adds to, tubes can be custom-fabricated to accommodate unique angles and sizes