Conjunctivo-rhinostomy with Métaireau tube implant: Outcomes and complications.

Abstract

Purpose: To communicate the results and complications in a series of 17 proximal lacrimal pathway obstructions (PLPO) operated by conjunctivo-rhinostomy (CR) with Métaireau tube implantation.

Methods: Retrospective descriptive study including 16 patients (17 PLPO) operated with CR between April 2010 and June 2017. Surgeries were performed under general anesthesia. The Métaireau tube implantation, draining into the middle meatus, was carried out through a trans-caruncular osteotomy with a 14G Abbocath catheter under endoscopic control.

Results: Twelve women (75%) and four men (25%) were included. The median age was 57 years (range 32-78). The indication for surgery was constant epiphora (Munk 4) due to obstruction less than 8 mm from the punctum. The follow-up time was 28 months (range 2-85). Epiphora improved one month after the intervention (Munk 0.35 ± 1) and at the end of follow-up (Munk 1.50 ± 1.10) compared to baseline values (Munk 4). The most frequent postoperative symptoms were hyperemia (35%), discharge (24%), and tearing (24%). The detected signs were conjunctival folds and papillomas at the proximal end of the tube (35% and 24%, respectively) and tube malposition (18%). One patient developed restrictive strabismus. 41% of the cases required at least one surgery to reposition or remove the tube.

Conclusions: CR with Métaireau tube implantation is a therapeutic alternative for PLPO. Despite the good anatomic results, patients should be warned about the potential complications, which are frequent and may require reoperations.