经泪小点泪道内窥镜治疗难治性泪道阻塞性疾病

Treatment of refractory lacrimal passage obstruction by endoscopy of the lacrimal drainage system

目的:探讨经泪小点泪道内窥镜治疗难治性泪道阻塞性疾病的疗效,评价其临床应用价值。方法:难治性泪道阻塞患者29例(32眼)于局麻下使用经泪小点泪道内窥镜系统进行泪道检查,并针对阻塞部位进行激光或电钻处理,泪道冲洗通畅后,注入3g/L妥布霉素+1mg/g地塞米松眼膏,术后随访6mo观察疗效。结果:全部患眼泪道均能被有效观察,术中再通率100%,术后随访治愈20眼(62%),好转5眼(16%),无效7眼(22%)。结论:经泪小点泪道内窥镜能对难治性泪道阻塞性疾病进行有效观察,并能进行有效的针对性治疗。

AIM： To investigate the effects of treatment for refractory lacrimal passage obstruction with endoscopy of the lacrimal drainage system and evaluate its clinical application. METHODS： Twenty-nine patients （32 eyes） with refractory lacrimal passage obstruction were examined by endoscopy of the lacrimal drainage system after local anesthesia, and the obstructions were treated with laser or micro-drill. Ointment with 3g/L tobramycin and lmg/g dexamethasone was injected into the lacrimal passage after unblocked irrigation. All patients were followed up after operation for 6 months. RESULTS： The scene in lacrimal passage of each eye could be observed effectively. All of the obstructions could be cleared in the operation. Twenty eyes （62%） were cured by the treatment, the symptom of 5 eyes （16%） were alleviated, and the treatment failed in 7 eyes （22%） in the follow up. CONCLUSION： The refractory lacrimal passage obstructions can be observed directly and treated with endoscopy of the lacrimal drainage system. It is an effective way to treat such diseases.