激光泪道成形术

Laser surgery for lacrimal duct obstruction

目的 探讨倍频 YAG激光及 Nd:YAG泪道激光行泪道成形术的疗效。方法 将带针芯的泪道探针按常规泪道探通方法探至泪道阻塞处 ,拔出针芯 ,将倍频 YAG或N d:YAG激光的光纤插入泪道探针达到泪道阻塞处 ,反复击射至击通为止。然后注入生理盐水及抗生素 ,术后泪道冲洗或进一步扩张 1wk～ 3mo不等。结果 共治疗 5 5 4眼 ,随访496眼 ,随访时间 3～ 2 2 m o,单纯性泪道阻塞经 1～ 2次治疗泪道通畅者 412眼。17眼外伤性泪道断裂吻合术后阻塞病例全部再通 ,慢性泪囊炎 5 6眼中 5 0眼治愈 ,复发者有 6例 ,其中再次激光治愈 3例 ,3例术后又发生阻塞。 11例泪囊鼻腔吻合术失败者 ,经激光治疗 8眼症状完全消失。结论 泪道激光治疗泪道阻塞性疾病安全有效 。

Objective To investigate effect of KTP YAG and Nd: YAG laser surgery for lacrimal duct obstruction.Methods First, a cannula was put in with probe in the routine way to find out the obstruction site. Then, after removal of the probe, the laser fiber of KTP YAG or Nd: YAG was conducted to the site and fire was set repeatedly until a breakthrough was gained. Finally the saline and antibiotic solutions were irrigated. Postoperatively irrigation or further dilation was carried out from 1 week to 3 months.Results ln 553 eyes, 496 of them were followed for 3～22 months. 412 eyes of simple obstruction got smooth irrigation after one or two laser surgeries; 17 eyes of canalicular obstruction after laceration repair got free irrigation again; 50 of 56 eyes of chronic dacryocystitis were cured, 6 failed (3 of them succeeded for second laser, 3 failed again); 8 of 11 eyes of failed dacryocystorhinostomy were cured after laser surgery without any symptoms.Conclusion Laser surgery is safe, effective for lacrimal duct obstruction with less complication.