Management of CPAP-Induced Ocular Air Reflux Due to a Porous Polyethylene-Coated Lester Jones Tube

Background

Continuous positive airway pressure (CPAP) is a common treatment for obstructive sleep apnea, in which a CPAP machine delivers, through a mask, a positive pressure in the airway to prevent them from collapsing during sleep. Under CPAP, ocular air reflux (air regurgitation) can occur in patients who had a conjunctivo-dacryocystorhinostomy [1], a lacrimal drainage surgical procedure in which a tears drainage tube (i.e., Lester-Jones tube) drains tears from the surface of the eye into the nasal cavity. Some Lester-Jones tubes are externally covered with a porous structure, porous polyethylene (Medpor^®, Porex Surgical Inc., Newnan, GA, USA), allowing this material to imbed itself in the surrounding tissue. Medpor^®-coated Lester-Jones tubes have the advantage to be more stable but have the disadvantage that, sometimes, it can be very difficult or even almost impossible to remove or reposition them.

The present paper appears to be the first report made in the literature of CPAP-induced ocular air reflux in the case of a nonremovable Medpor^®-coated tears drainage tube as well as the management of CPAP-induced ocular air reflux using a “finger-like” external compression bandage.

• References

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