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목적 : Bacterial infection and malposition of Jones tubes are frequent complications after conjunctivodacryocystorhinostomy (CDCR) with the Lester Jones tube insertion.The authors describe the types of bacterial infection associated with Jones tube and various ways of management.
방법 : A retrospective analysis was performed on 30 patients who experienced symptoms of periocular infection associated with a Lester Jones tube. All Jones tube were cultured to identify bacteria and tested for their antibiotic sensitivity.
결과 : Fourteen men and 16 women were included in the analysis. The species of cultured bacteria were methicillin-resistant staphylococcus aureus (MRSA) in 20 cases, staphylococcus aureus in 7 cases, pseudomonas and enterobacter in 4 cases in each.Topical ocular vancomycin and oral rifampicin were applied for 20 MRSA infected cases with biofilms removal, and the periocular symptoms started to resolve after 1 week.Six MRSA infected cases needed to relocate or exchange the Jones tube.Three patients received reverse canaliculo-dacryocystorhinostomy with a Jones tube removal, and no recurrence occured.
결론 : A medical treatment of vancomycin eye drop combined with oral rifampicin for persistent MRSA infection associated with Lester Jones tube showed a successful results. If Jones tube is dislocated, repositioning is highly recommended to prevent recurrence of periocular bacterial infection before or after medication. However, a reverse canaliculo-DCR can be considered for recurrent malposition of the Jones tube when only the distal part of canaliculus is obstructed and remnant lacrimal sac is available.
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