Restrictive strabismus following Jones tube insertion: A case series of 8 patients

Background: Restrictive strabismus and diplopia are an uncommon complication of conjunctivo-dacryocystorhinostomy, with insertion of the Lester-Jones tube. A literature review revealed only 4 published reports of this complication with a total of 4 patients affected. Methods: We report on a series of 8 patients who presented with restrictive strabismus and diplopia following Jones tube insertion. Results: Time to presentation was variable and was found to occur from several months to as long as 6 years after insertion. Treatment included topical steroid therapy initially. Surgery was done to release adhesions and scarring if topical treatment failed. Mitomycin C was used in 2 patients. Only 4 of the 8 patients had successful resolution of their diplopia with either therapy. Interpretation: Diplopia following Jones tube insertion is an infrequent complication of surgery. Medical or surgical therapy can be help resolve symptoms but is often unsuccessful.