泪道内镜联合硅胶管置入治疗下泪小管阻塞的临床研究

Clinical efficiency of lacrimal endoscopic intubation of silicone tube in treatment of lacrimal canaliculi obstruction

目的：研究泪道内镜治疗下泪小管阻塞的临床疗效。方法选择自2014年3月收入本院的24例下泪小管阻塞的中老年患者（平均年龄65岁，24只患眼），将泪道内镜插入患者泪道，直视下找到下泪小管阻塞部位用980激光清除阻塞处组织，使泪道通畅后，将硅胶管置入下泪小管并固定。结果24例眼泪下泪小管阻塞患者在泪道内镜联合硅胶管置入治疗后，随访3个月，泪道通畅18例，泪道阻塞6例。结论泪道内镜可以直接找到阻塞部位，980激光治疗损伤最小，下泪小管生理结构可恢复，术后反应轻。而联合硅胶管置入使泪道临床再通率提高，两者结合是下泪小管阻塞理想的治疗方法。

Objective To determine the clinical efficacy of lacrimal endoscope in the obstruction of lacrimal canaliculi. Methods Totally 24 aged patients （mean age 65 years, 24 eyes） with lacrimal canaliculi obstruction in our department from March 2014 were subjected in this study. After the lacrimal endoscope was inserted into the lacrimal canaliculi to explore the blockage, the block organization was removed with the help of 980 laser to make the lacrimal duct unobstructed. Then a silicone tube was placed and fixed in the lacrimal canaliculi. Results The cohort was followed up for 3 months after the silicone tube intubation with lacrimal endoscopy. There were 18 cases succeeded with unobstructed lacrimal duct, and the other 6 cases failed. Conclusion Lacrimal duct endoscopy is helpful to directly find the blockage, and 980 laser makes minimal damage and restores the physiological structure of lacrimal canaliculi with mild postoperative impairment. Combined with silicone tube intubation, this treatment is ideal in treatment of the obstruction of lacrimal canaliculi.