text: Lacrimal Bypass Tube - The Stoneygate Eye Hospital - Leicester
  What is Lacrimal Bypass Tube?
  A Lester Jones tube is typically used in patients for whom previous lacrimal drainage operations (DCR) have not been successful (this is more likely in those with prior canalicular disease).
  As a DCR will already have been performed in most patients who require a tube, an LJT can be placed under a brief general or local anaesthetic by creating a track between the inner corner of the eyelids and the nasal passage, passing the tube over a blunt-tipped guide wire to lie within this track. This is usually undertaken with the use of an endoscope and instruments placed inside the nose so that no visible skin incisions are necessary. Occasionally, where there is a significant deviation of the nasal septum, there may be insufficient nasal space to place a tube. A septoplasty may be required to improve the nasal space in such patients before a tube can be placed.
  The procedure itself takes between 30 to 45 minutes, and patients generally return home the same day. Administrative work can be recommenced within a day or two, with full return to work within a week.
  A fine suture (stitch) is usually placed around the neck of the tube and removed in clinic after one or two weeks. Thereafter, a review in clinic is required every 12 months to ensure that the tube is clean and has not moved into an abnormal position.
  It should be brought without delay to a casualty department (with ophthalmic facilities) for it to be replaced. If this cannot be achieved as an outpatient, then a new tube will need to be inserted routinely under local or general anaesthesia.