Restrictive Strabismus and Diplopia 2 Years After Conjunctivodacryocystorhinostomy With Medpor-Coated Tear Drain.

Abstract

A 19-year-old woman who underwent conjunctivodacryocystorhinostomy with Medpor-Coated Tear Drain 2 years ago presented with diplopia on left gaze for 4 months. Limitation of extraocular movement of OS on left gaze was observed on duction test. The forced duction test revealed restriction of the left medial rectus muscle. Orbital MRI demonstrated an enhancing soft tissue lesion surrounding the tube in inferomedial aspect of left orbit. Removal of the tube and adhesiolysis were performed. Histologic findings were consistent with a chronic inflammation with fibrosis. After surgery, limitation of extraocular movement and diplopia were completely resolved. Jones tube coated with a thin layer of porous polyethylene allows the ingrowth of fibrovascular tissue into the coating, decreasing the probability of tube extrusion, but can also accelerate fibrotic changes around the tube causing restrictive strabismus.

• Authors: Dong Hoon Shin, Yoon-Duck Kim, Chung-Hyun Lee, Owen N Johnson 3rd, Kyung In Woo
• Journal: Ophthalmic plastic and reconstructive surgery (Ophthalmic Plast Reconstr Surg) 2015 Nov-Dec Vol. 31 Issue 6 Pg. e159-62 ISSN: 1537-2677 [Electronic] United States
• PMID: 24914690 (Publication Type: Case Reports, Journal Article)

Chemical References

• Coated Materials, Biocompatible
• Medpor
• Polyethylenes

Topics

• Coated Materials, Biocompatible
• Conjunctiva (surgery)
• Dacryocystorhinostomy (instrumentation)
• Diplopia (diagnosis, etiology)
• Female
• Humans
• Intubation
• Magnetic Resonance Imaging
• Ophthalmologic Surgical Procedures
• Polyethylenes
• Postoperative Complications
• Prostheses and Implants (adverse effects)
• Strabismus (diagnosis, etiology)
• Young Adult