双极电凝治疗结膜松弛致溢泪的临床观察

Thermocautery for Conjunctivochalasis with epiphora

目的观察双极电凝治疗结膜松弛致溢泪的效果。方法 2011年3月至2013年11月因结膜松弛致溢泪患者49例（52只眼）。男40例,女9例;年龄（61.58±3.4）岁;结膜松弛分级Ⅰ级7只眼,Ⅱ级27只眼,Ⅲ级18只眼;溢泪时间6~72个月,平均8个月。予双极电凝治疗,观察溢泪症状及结膜松弛分级的变化。结果术后2周溢泪症状消退17只眼（32.7%）,溢泪改善35只眼（67.3%）。术后4周溢泪消退40只眼（76.9%）,溢泪改善12只眼（23.1%）,术后8周溢泪消退42只眼（80.8%）,溢泪改善10只眼（19.2%）。术后4周效果好于术后2周（P〈0.05）,术后8周较术后4周无明显变化（P〉0.05）。术后8周结膜松弛Ⅰ级、Ⅱ级、Ⅲ级的分级降低率分别为100.0%、92.6%、94.4%,总的降低率为94.2%。未见明显不良反应发生。结论双极电凝治疗Ⅱ~Ⅲ级结膜松弛引起的溢泪方便有效。

OBJECTIVE To evaluate the effects of thermocautery for Conjunctivochalasis with epiphora. METHODS Fifty-two eyes of 49 patients with epiphora of various grades of conjunctivochalasis were treated with themocautery between Novemember 2011 to 2013 in our hospital. There were 40 male and 9 female cases. The mean age of the patients was 61.58±3.4 years（±SD）. The epiphora time was 6~72 months. The mean follow-up period was 8 months. RESULTS After the thermocautery, in the second weeks, the epiphora disappeared in 17 eyes （32.7%） and improved in the remaining 35 eyes （67.3%）. In the fourth week, the epiphora disappeared in 40 eyes （76.9%） and improved in the remaining 12 eyes （23.1%）. In the eighth week, the epiphora disappeared in 42 eyes （80.8%） and improved in the remaining 10 eyes （19.2%）. There was a significant difference between the second week and the forth week （P〈0.05）. There was not a significant difference between the forth week and the eighth week （P〉0.05）. The total decreased rate was 94.2%.When the grade reduction rates were calculated, the reduction rates of grade Ⅰ, Ⅱ and Ⅲ were 100%, 92.6% and 94.4% respectively. CONCLUSIONS Thermocautery was an effective treatment for the Ⅱ and Ⅲ grade Conjunctivochalasis.