KTP激光泪道成形术联合微孔导管植入术治疗难治性泪道阻塞

Effect of KTP Nd ∶YAG laser recanalisation combined with implantation of small hole ductus on refactory dacryagogatresia

目的:观察KTP激光泪道成形术联合微孔导管植入术治疗难治性泪道阻塞的临床疗效。方法:将难治性泪道阻塞患者50例按年龄、性别及阻塞部位相匹配随机分为A,B两组:A组25例为治疗组行KTP激光泪道成形术联合微孔导管植入术,术后用庆大霉素地塞米松及糜蛋白酶的混合液冲洗泪道1次/wk至术后1mo,1mo后拔除导管,以后3mo内每月冲洗泪道1次,随访6～12mo;B组25例为对照组,行KTP激光泪道成形联合药物灌注术,术后泪道冲洗及随访同A组,分别观察两组的疗效。结果:在泪小(总)管阻塞中,A,B两组的治愈率分别是80%,30%;在鼻泪管阻塞中,A,B两组的治愈率分别是66.7%,26.7%。无论是泪小(总)管阻塞,还是鼻泪管阻塞,A,B两组的治愈率均有显著差异(P<0.05)。结论:KTP激光泪道成形术联合微孔导管植入术是治疗难治性泪道阻塞的有效方法。

AIM. To evaluate therapeutic effect of KTP Nd ： YAG laser recanalisation combined with implantation of small hole ductus on refactory dacryagogatresia. METHODS： Fifty cases of refactory dacryagogatresia were randomly divded into two groups： group A and group B. Group A was treated by KTP Nd ： YAG laser recanalisation combined with implantation of small hole ductus ; lacrimal duct was irrigated with gentamicin, hexadecadrol and chymotrypsin mixed liquor 1 time everyweek for 1 month, and small hole ductus was removed 1 month after surgery. And then lacrimal duct was irrigated 1 time everymonth for 3 months. The follow- up lasted for 6 to 12 months. Group B was control group which was treated by KTP Nd ： YAG laser recanalisation combined with Tobra Dex eye ointment infusion. Irrigating of lacrimal duct and the follow-up time were the same as that of group A. The therapeutic effects of two groups were evaluated respectively. RESULTS, The cure rates of group A and group B were 80%, 30% in canaliculus obstruction respectively, and 66. 7%, 26.7% in nasolacrimal duct obstruction respectively. The difference of cure rates between two groups was all statistically significant in canaliculus and nasolacrimal obstruction. CONCLUSION： KTP Nd ：YAG laser recanalisation combined with implantation of small hole ductus seems to be an effective method for treating difficult cured dacryagogatresia.