Recurrent Jones tube extrusions successfully treated with a modified glass tube.

Displacement or extrusion of the standard glass Jones tube causes conjunctivodacryocystorhinostomy to fail in many cases. Patients who have had trauma, a tumor excised, or have received radiation therapy in the medial canthal area are particularly susceptible to this complication. Gladstone and Putterman developed a modified glass tube that has a second flange 3 to 6 mm from the top flange. The second flange anchors the tube and reduces its mobility. Eleven patients who could not retain a standard Jones tube were fitted with a modified glass tube. Seven of these patients were able to wear the originally placed modified tube comfortably. Two additional patients extruded the originally placed modified tube but were able to retain a shorter modified tube. Follow-up ranged from 3 weeks to 49 months (average, 22.4 months).