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Title Comparative survival of Stoploss Lester Jones Tubes (SLJT) and Lester Jones Tubes (LJT)
Submitted by Kailun Jiang
Abstract Number 105
Review Result rapid fire presentation
Purpose

Extrusion is the most common cause of failure in LJT. To reduce this complication, SLJT with a distal flange-skirt have been designed. In the author’s department, SLJT are offered to patients with multiple previous LJT failures 2nd to extrusion. This study analyzed the comparative survival of these SLJTs with their previous LJTs and control patients with LJTs only.

Methods

Retrospective review of consecutive LJT or SLJT inserted between Jan 2014-Dec 2016.

Results

28 eyes of 23 patients had 31 SLJTs. Prior to their SLJT, they had 116 failed LJTs. 47 eyes of 36 patients had 61 LJTs only. The average age of both groups was 63 years. Complex medial canthal conditions accounted for 52% of SLJT group and 19% of LJT-only group. Compared to their previous LJTs, the SLJTs were less likely to extrude (3% SLJT vs 72% prior LJT), but were more likely to sink in (26% SLJT vs 13% prior LJT). The median survival of LJTs in those who went on to have a SLJT was 3.5 months. SLJTs were able to lengthen the median survival to 26 months in this group, which was statistically significant (P<0.0001).
While extrusion was also the most common complication in the LJT-only group, this occurred only in 20% of eyes. Tube failure from sinking in occurred in 14% of eyes. The median survival in this group was 25.5 months and was not statistically different from the SLJT group (p=0.4497).

Conclusion

SLJTs significantly increased the median survival of conjunctivodacryorhinostomy bypass in patients prone to LJT failure. SLJTs are able to rescue this group allowing them to regain a similar survival curve to the less complicated LJT-only group. Rates of tube extrusion are significantly reduced using the SLJT, but frequency of sinking in is increased.


Additional Authors
Last name Initials City / Hospital Department
Jiang K London/Moorfields Eye Hospital
Timlin H London/Moorfields Eye Hospital
Mathewson P London/Moorfields Eye Hospital
Manta A London/Moorfields Eye Hospital
Wong K London/Moorfields Eye Hospital
Ezra D London/Moorfields Eye Hospital