泪道激光成形联合新型泪道引流管留置术治疗泪道阻塞的临床观察

Clinical observation of laser dacryocystoplasty combined with new lacrimal drai-nage tube indwelling surgery for obstruction of lacrimal passage

目的探讨泪道激光成形联合新型泪道引流管留置术治疗泪道阻塞的治疗效果。方法89例(95眼)泪道阻塞患者行Nd:YAG激光成形联合新型泪道引流管留置3个月,拔管后随访3～12个月,观察流泪和流脓情况、泪道功能恢复及并发症情况。结果末次随访时,经此方法治疗各种泪道阻塞的患者治愈72眼,占75.79%;有效15眼,占15.79%;无效8眼,占8.42%,总有效率91.58%。其中泪小管阻塞者有效率100.00%(23/23),泪总管阻塞者有效率100.00%(12/12),鼻泪管阻塞者有效率94.44%(34/36),泪小管合并鼻泪管阻塞者有效率85.71%(12/14),慢性泪囊炎者有效率60.00%(6/10)。3眼术后2周左右有轻微眼部刺激症状,4眼出现泪小管周围组织红肿不适,1眼出现泪小点撕裂,因假道形成致眼睑肿胀1眼,无一例患者出现泪道插管滑脱,余未见其他并发症发生。结论泪道激光成形联合新型泪道引流管留置术治疗泪道阻塞是一种有效的治疗方法。

Objective To investigate the clinical efficacy of laser dacryocystoplasty combined with new lacrimal drainage tube indwelling surgery for obstruction of lacrimal passage.Methods A total of 89 patients（95 eyes） with obstruction of lacrimal passage were treated with Nd：YAG laser dacryocystoplasty combined with new lacrimal drainage tube indwelling surgery for 3 months.All patients were followed up for 3 months to 12 months.Lacrimation,suppuration,recovery of lacrimal passage function and complications were observed.Results At the last following up time,72 eyes（75.79%） were cured,15 eyes（15.79%） were with effective treatment,8 eyes（8.42%） were uneffective,and the total effective rate was 91.58%.The effective rates were 100.00%（23 cases in 23 cases） in patients with obstruction of lacrimal ductule,100.00%（12 cases in 12 cases） in patients with obstruction of lacrimal canaliculus,94.44%（34 cases in 36 cases） in patients with obstruction of nasolacrmal canal,85.71%（12 cases in 14 cases） in pateints with obstruction of lacrimal ductule and nasolacrimal canal and 60.00%（6 cases in 10 cases） in patients with chronic dacryocystitis.Three eyes were with mild irritation at about postoperative 2 weeks,4 eyes were with red swelling of lacrimal ductule,1 eye was with laceration of lacrimal punctum and 1 eye was with eyelid swelling induced by false passage.No other complication was found.Conclusion Laser dacryocystoplasty combined with new lacrimal drainage tube indwelling surgery is an useful method for obstruction of lacrimal passage.