泪道浚通联合硅胶管植入术治疗上泪道阻塞的疗效观察

Combination of high-frequency electrolacryocystoplasty and silicone intubation for superior lacrimal passage obstruction

目的观察泪道浚通联合硅胶管植入术治疗上（全）泪道阻塞的手术疗效。方法浚通泪道后，在“软泪道探针”的辅助下，从泪小点植入硅胶管，留置3—6个月后拔管。结果共治疗患者415例471眼，硅胶管平均留置3．4个月，拔管后平均随访15．1个月，随访率为96．18％。共治愈349眼（77．04％），好转39眼（8．61％），失败65眼（14．35％），总有效率为85．65％。术后出现泪小点撕裂12眼（2．65％），硅胶管部分脱出8眼（1．77％），泪小管息肉3眼（0．66％），无其他并发症。结论泪道浚通联合硅胶管植入术损伤性小、成功率高、并发症少，是治疗上（全）泪道阻塞的良好选择。

Objective To evaluate the therapeutic effects of high-frequency electrolacryocystoplasty combining with silicone intubation in the treatment of superior and full-length lacrimal passage obstruction in adults. Methods The combination procedure of high-frequency electrolacryocystoplasty and silicone intubation was performed in 415 patients （471 eyes） from Jan 2003 to March 2005. Obstructed tissue in the lacrimal passage was cleared by electrolacryocystoplasty and silicone tube was putted through canaliculi into the nasal cavity under the guiding of ＂soft probe＂. Tube was kept in place for 2.1 to 5.3 months（mean 3.4 months）after surgery. Mean follow-up time after tube removal was 15.1 months, and the follow-up rate was 96. 18%. Results Symptoms was completely resolved in 349 eyes （77.04%）and improved in 39 eyes （8.61%）and reoccurred in 65 eyes（ 14. 35% ）. The overall successful rate of surgery was 85.65%. Complications included puncta slitting in 12 eyes （2.65 % ） , tube displacement in 8 eyes （1.77%）and canalicular granuloma formation in 3 eyes （0. 66% ）. Fifteen patients （18 eyes）were lost during the follow-up period. Conclusion This is a safe and an effective technique for superior or fulllength lacrimal passage obstruction in adult because of its less invasive nature and complications as well as higher successful rate. It may serve as an alternative method for the treatment of superior and full-length lacrimal passage obstruction.