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:
Recovery time is significant
An incisional scar might develop due to invasive procedure
Potential for excess bleeding
May not be necessary for partial obstructions
goal: anastomosis between lacrimal sac and nasal cavity (middle meatus)
decreased success with prior nasal fractures, children, nasal mucosal disease, broad flat nasal bridge, and re-operation
|3 weeks after left DCR, incision is barely noticeable|
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 .
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.
The balloon catheter is then repositioned slightly higher in the duct and inflated twice as in step 2.
The balloon catheter is then deflated and removed.
Here you can see the balloon as it is inflated within the nose
If the "tear duct" obstruction is beyond repair, It might 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.
These might 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 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
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