Postherpetic lacrimal obstruction

Objective: The purpose of the study was to review the surgical management o f postherpetic lacrimal obstruction. Design: Retrospective noncomparative case series. Participants: One hundred sixty patients (111 female, 49 male) with a mean age at presentation of 31 years. All had a history typical of primary herpe s simplex blepharoconjunctivitis. Intervention: Open lacrimal surgery was performed on 158 patients (171 eyes ), of whom 99 patients (108 eyes) had undergone no surgery before being see n at Moorfields, The most common primary procedure was dacryocystorhinostom y (DCR) with anterograde or retrograde intubation (94 eyes, 54%), and prima ry placement of a Lester Jones tube (conjunctivo-DCR) was performed in 56 e yes (32%), A secondary procedure was required in 43 eyes (26%), the most co mmon being closed placement of a Lester Jones tube (40 eyes). Main Outcome Measures: Persistent symptoms of impaired lacrimal drainage an d need for additional surgery. Results: Reduction of epiphora was good or complete in 171/173 eyes (98%). Conclusions: This study shows that there is a justification for procedures that use any remaining unaffected portion of canaliculi, such as DCR, with anterograde or retrograde intubation, as well as the more commonly used Les ter Jones tube. (C) 2000 by the American Academy of Ophthalmology.