泪阜-泪小管探查口术临床应用观察

Treatment of lacrimal canalicular obstructions by carunculo canalicular vent

目的 探讨泪阜 -泪小管探查口术 (CCV)能否判断泪小管阻塞的位置及长度 ,并藉以有效地治疗泪小管阻塞。方法 在相对于泪阜的位置行 2mm深度的睑缘皮肤切口 ,暴露泪小管 ,探查口开放者 ,处理如下 :小疤痕者直接用探针刺穿疤痕 ,全层切除睑缘疤痕 ,在阻塞远端附近作一人工泪点。探查口阻塞者 ,用穹隆部结膜鼻腔吻合术 (DFR)治疗。结果 1年后所有用CCV治疗泪小管阻塞的患者 ,全部泪小管通畅及排泪正常。结论 CCV能有效地定位距泪小点 5～ 6mm的泪小管阻塞。

Objective To determine the efficiency of the carunculo canalicular vent(CCV) with the object of not only identifying the length and location of the canalicular obstructions,but also as a useful approach treating them. Methods A 2 mm deep incision was made in front of the lacrimal caruncle by indentifying the canaliculus.Occluded canaliculi which were patent at the level of CCV was treated through the punctum after passing through a very small scar(9 cases),through the punctum after cutting a full thickness wedge of lid margin encompassing the scar(5 cases),or by passing the obstruction and creating an artificial punctum near the medial end of the scar(3 cases).The other 12 cases were also occluded at CCV level,and a dacryo fornix rhinostomy(DFR) was performed in them. Results All cases of the occluded canaliculi patent at the level of the CCV and being treated by CCV remained anatomically and functionally patent a year after surgery. Conclusion CCV is a good approach to locate the medial end of the obstruction in cases where the canalicular obstruction begins in the first 5～6*!mm of the canaliculus.Moreover,the information gathered through the CCV would determine the subsequent approach to the treatment.