• Mark R. LevineEmail author
  • C. Blake Perry
  • Eric A. Steele
  • Yoon-Duck Kim


Dacryocystorhinostomy (DCR) is a drainage procedure that bypasses the site of obstruction in the nasolacrimal duct system. The procedure is performed in adults and children who have chronic epiphora and dacryocystitis secondary to partial or complete nasolacrimal duct obstruction. DCR with Jones tube is performed after a failed DCR and subsequent revisions, common canalicular obstruction, or stenosis. The goal is to directly bypass the canaliculus and lacrimal system.


Dacryocystitis Dacryocystorhinostomy Lacrimal sac Jones tube CDCR Nasal lacrimal duct obstruction Epiphora 

Supplementary material

419986_5_En_9_MOESM1_ESM.mp4 (70.6 mb)
Video 9.1 Application of local anesthesia for dacryocystorhinostomy. Courtesy of Richard C. Allen, MD, PhD, FACS. (MP4 72243 kb)
419986_5_En_9_MOESM2_ESM.mp4 (257.6 mb)
Video 9.2 External dacryocystorhinostomy. Courtesy of Richard C. Allen, MD, PhD, FACS. (MP4 263826 kb)
419986_5_En_9_MOESM3_ESM.mp4 (288.2 mb)
Video 9.3 External dacryocystorhinostomy. Courtesy of Richard C. Allen, MD, PhD, FACS. (MP4 295167 kb)
419986_5_En_9_MOESM4_ESM.mp4 (135.9 mb)
Video 9.4 Jones tube placement. Courtesy of Richard C. Allen, MD, PhD, FACS. (MP4 139111 kb)
419986_5_En_9_MOESM5_ESM.mp4 (110.7 mb)
Video 9.5 Jones tube placement. Courtesy of Richard C. Allen, MD, PhD, FACS. (MP4 113335 kb)
419986_5_En_9_MOESM6_ESM.mp4 (66.9 mb)
Video 9.6 Jones tube placement. Courtesy of Richard C. Allen, MD, PhD, FACS. (MP4 68534 kb)
419986_5_En_9_MOESM7_ESM.mp4 (56.3 mb)
Video 9.7 Jones tube placement (“crescent twist”). Courtesy of Richard C. Allen, MD, PhD, FACS. (MP4 57689 kb)

Suggested Readings

  1. 1.
    Bagdonaite L, Pearson AR. Early experience with the StopLoss Jones tube. Orbit. 2015;34(3):132–6.CrossRefPubMedGoogle Scholar
  2. 2.
    Dailey RA, Tower RN. Frosted Jones Pyrex tubes. Ophthal Plast Reconstr Surg. 2005;21(3):185–7.CrossRefPubMedGoogle Scholar
  3. 3.
    Fan X, Bi X, Fu Y, Zhou H. The use of Medpor coated tear drainage tube in conjunctivodacryocystorhinostomy. Eye (Lond). 2008;22(9):1148–53.CrossRefGoogle Scholar
  4. 4.
    Gladstone GJ, Putterman AM. A modified glass tube for conjunctivodacryocystorhinostomy. Arch Ophthalmol. 1985;103(8):1229–30.CrossRefPubMedGoogle Scholar
  5. 5.
    Mombaerts I, Colla B. Modified Jones’ lacrimal bypass surgery with an angled extended Jones’ tube. Ophthalmology. 2007;114(7):1403–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Steele EA, Dailey RA. Conjunctivodacryocystorhinostomy with the frosted Jones Pyrex tube. Ophthal Plast Reconstr Surg. 2009;25(1):42–3.CrossRefPubMedGoogle Scholar
  7. 7.
    Witters E, Mombaerts I. The survival of an angled extended Jones’ tube. Br J Ophthalmol. 2015;99(11):1523–6.CrossRefPubMedGoogle Scholar
  8. 8.
    Lim C, Martin P, Benger R, Kourt G, Ghabrial R. Lacrimal canalicular bypass surgery with the Lester Jones tube. Am J Ophthalmol. 2004;137(1):101–8.CrossRefPubMedGoogle Scholar
  9. 9.
    Bagdonaite L, Pearson AR. Twelve-year experience of Lester Jones tubes-results and comparison of 3 different tube types. Ophthal Plast Reconstr Surg. 2015;31(5):352–6.CrossRefPubMedGoogle Scholar
  10. 10.
    Jones LT, Wobig JL. Surgery of the eyelids and lacrimal system. Birmingham, AL: Aesculapius Pub. Co.; 1976.Google Scholar
  11. 11.
    Ahn ES, Dailey RA, Radmall B. The effectiveness and long-term outcome of conjunctivocystorhinostomy with frosted Jones tubes. Ophthal Plast Reconstr Surg. 2016;33(4):294–9.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Mark R. Levine
    • 1
    • 2
    • 3
    Email author
  • C. Blake Perry
    • 4
  • Eric A. Steele
    • 5
  • Yoon-Duck Kim
    • 6
  1. 1.Case Western Reserve University School of MedicineClevelandUSA
  2. 2.Department of OphthalmologyUniversity Hospitals of ClevelandClevelandUSA
  3. 3.Cleveland Clinic FoundationClevelandUSA
  4. 4.Kaestner Aesthetic Eye CenterEncinitasUSA
  5. 5.Oregon Health and Science University, Casey Eye InstitutePortlandUSA
  6. 6.Department of OphthalmologySamsung Medical Center, Sungkyunkwan University, School of MedicineSeoulKorea

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