punctual stenosis

[SueRL]

What is the usual treatment for punctual stenosis?
Is any type of snip procedure ever used and if so, does it leave visible scars?
Are any type of tubes ever used?
Thanks,
Sue

[Andrea_77]

Where can I find a description of the one snip procedure? Or the 2 or 3 snip procedures? I can seem to only find links for scholarly studies/reports but nothing that describes how it's done or what the recovery is like.

[John C Hagan III, MD, FACS, FAAO]

1. The openings of the tear system on the eyelids (puncta) are stretched open, then a think tube like material of silastic or similiar material is threaded through the upper opening into the lower opening and pulled outside then tied in a knot. The tubing is left in place for weeks to months to keep the puncta and drainage system from stenosising (scarring shut).
2. It ithe Jones procedure you give up on the upper drainage system and excise the tissue at the inner aspect (caruncle) down to the tear sac then put a funnel shaped tube into the sac that drains the tears into it. This is the Jones Tube.

Look at this reference:
http://images.google.com/imgres?imgurl=http://www.ophthalmol.com/images/tear_drainage.gif&imgrefurl=http://www.ophthalmol.com/print.php%3Farticle%3Depiphora%26title%3DEpiphora&h=280&w=363&sz=25&hl=en&start=1&um=1&usg=__JJT-uIfnRViiqEoMrwuvgHEhKHA=&tbnid=z0JjSAi92qh_HM:&tbnh=93&tbnw=121&prev=/images%3Fq%3Dtear%2Bdrainage%2Bsystem%2Bsurgery%2B%2BJones%26gbv%3D2%26um%3D1%26hl%3Den%26sa%3DG

I will not be able to continue this discussion further. You will need to do your own research or discuss this with your personal Eye MD.

JCH MD

[SueRL]

What is exactly done when dilation and intubation for performed for upper system?
Does that mean a Jones tube is put in?
Thanks,
Sue

[John C Hagan III, MD, FACS, FAAO]

1. No it doesn't interfer
2. DCR is for blockage at the lower drainage system, dilation and intubation is for blockage at the upper system.

JCH MD

[SueRL]

If a 1, 2, or 3 snip procedure fails, does it in anyway interfere with  a future dilation and intubation?
How does a dilation and intubation differ from a DCR?
Thanks,
Sue

[John C Hagan III, MD, FACS, FAAO]

1-2-3 snip is like small medium large.

Part of a Jones tube is done externally in part since the tube goes at the inner of the corner of the eye and must be inserted externally. The rest can be done by some oculoplastic surgeons so that there is no scar on the inner lower lid.

JCH MD

[SueRL]

Second reply to your post.
Just did some reading about the one snip procedure.

It mentioned two snip and three snip procedures also.
Under what circumstances would either of those be done?
And are there risks to either of them?
Thank you.
Sue

[SueRL]

Can Jones tube be done endonasally?  If so, would that leave scars?
Thanks

[John C Hagan III, MD, FACS, FAAO]

From easiest to hardest:   Dilation,  one snip procedure, dilation and intubation,  last resort Jones tubes.    None of the first three leave any scars.

JCH MD