改良泪点息肉切除联合Nd∶YAG激光治疗泪点息肉疗效观察

Curative effect observation on improvement polypectomy combined Nd∶YAG laser therapy for acrimal punctum polyps

目的 观察改良泪点息肉切除术联合泪道激光治疗泪点息肉的疗效.方法 对2012年6月至2013年7月在河南省眼科研究所门诊就诊的26例（41只眼）泪点息肉患者实施改良手术治疗,高倍显微镜下剪除泪点息肉,切缘不超过泪点周围的结缔组织环,留取息肉组织标本HE染色.泪点成形后,用Nd∶ YAG泪道激光对出血点发射,凝固止血,并对泪点的切缘出血点进行适当烧灼封闭.术后裂隙灯显微镜下观察泪点形态、位置及周围组织情况.结果 患者溢泪症状均消失,泪点开口通畅,位置正常,边界清晰无粘连,泪道冲洗通畅,随访1年内未见泪点息肉复发.结论 手术切除是治疗泪点息肉的有效办法,改良泪点息肉切除,联合泪道激光凝固止血,最大限度地使泪点在解剖上保持正常位置、形态和生理功能.

Objective To observe the curative effect on improvement polypectomy of lacrimal punctum combined with laser treatment of lacrimal punctum polyps.Methods Forty-one eyes of 26 patients with lacrimal punctum polyps at Henan Eye Institute were prospectively assessed from June 2012 to July 2013.All patients were performed improvement polypectomy of lacrimal punctum in the operating room under the surgical microscope.During the operation,the polyps was pruned and kept polyps tissues to hematoxylin and eosin stain.After the polypectomy,Nd∶YAG laser were used to emission and coagulation the bleeding point.All patients continued to be followed up for 1 month to 1 year.Results All patients were cured,the puncta opening easy and smooth without any relapse,the lacrimal irrigation was normal.As so far,there was no lacrimal punctum polyps recurrence.Conclusions Improved polypectomy of lacrimal punctum combined with laser for the treatment of lacrimal punctum polyps is effective.The incision edge is limited within the connective tissue ring arounding puncta,such keeping the normal location and shape and physiologic function maximatily.