Sir,

We all known that the ideal bypass tube should be hydrophobic, and there should be some rigidity, good biocompatibility, and less displacement or extrusion. It can be made up of various materials. Although the pyrex tube is successful in the majority of patients in relieving tearing, the main shortcoming of a Jones tube is extrusion. Using the Medpor tube as bypass tube, an improvement or complete relief of epiphora was achieved in most cases, and the tube extrusion or displacement was not seen in our study, although the rate of tube obstruction was higher than that reported in earlier studies.

Many doctors try to find an ideal bypass tube, but unfortunately all forms of artificial tear drainage replacement may be associated with either short- or long-term complications. It is still a hard and challenging work for all ophthalmologists.