Long-term outcomes of laser dacryoplasty combined with intubation using a new silicon tube in patients with lacrimal duct obstruction

AIM:To determine the 15-year outcomes of laser dacryoplasty(LDP)in patients with lacrimal duct obstruction;and to evaluate LDP combined with intubation using a new silicone tube to treat complicated cases.METHODS:Patients with lacrimal duct obstruction and treated with LDP between April 2000 and April 2005 were investigated retrospectively.Totally 116 eyes with completed 15-year follow-up records were included in this study.For complicated cases(52 eyes of 52 patients),both LDP and intubation using a self-made silicon tube were performed.For patients with uncomplicated obstruction(64 eyes of 61 patients),only LDP was performed.Outcomes were assessed based on results of lacrimal irrigation and degree of symptoms during follow-up.RESULTS:At the follow-up time of 15y,81 eyes achieved full success(69.8%);21 eyes got improved(18.1%);and 14 eyes were considered failure(12.1%).The success rate was 71.2%(37/52 eyes)for complicated cases;and 68.8%(44/64 eyes)for uncomplicated cases.No statistically significant difference between two groups was observed(P=0.961).No postoperative complication was observed.CONCLUSION:LDP is a well-tolerated,simple,and effective procedure with satisfactory long-term outcomes in selected patients,which make it a good alternative to conventional dacryocystorhinostomy.In addition,intubation with the self-made mono-canalicular silicone tube facilitates the management of complicated cases with few complications.

A comparison between monocanalicular and pushed monocanalicular silicone intubation in the treatment of congenital nasolacrimal duct obstruction

AIM: To compare the success rate of monocanalicular versus pushed monocanalicular silicone intubation(PMCI)of the nasolacrimal duct for congenital nasolacrimal duct obstruction(CNLDO).METHODS: In a prospective randomized clinical trial 53 eyes of 49 patients with CNLDO underwent either monocanalicular silicone intubation(MCI)(n =28 eyes) or PMCI(n =25 eyes). All procedures were performed by 1oculoplastic surgeon. Treatment success was defined as the complete resolution of epiphora at 3mo after tube removal.RESULTS: The surgical outcome was assessed in 20 eyes with MCI and 20 eyes with PMCI. The mean age of treatment was 26.25 ±10.08mo(range, 13-49mo) for MCI and 26.85±12.25mo(range, 16-68mo) for PMCI. Treatment success was achieved in 18 of 20 eyes(90.0%) in the MCI group compared with 10 of 20 eyes(50%) in the PMCI group(P =0.01). In the PMCI group, the tube loss(30%)was greater than the MCI group(5%), however the differences between the 2 groups proved to be not significant(P =0.91).CONCLUSION: Our results indicate that MCI has higher success rate in CNLDO treatment compared with PMCI in this small series of patients.

Primary non hodgkin's lymphoma of lacrimal sac presented as recurrent acute dacryocystitis: A case report

Primary non Hodgkin's lymphoma of the lacrimal sac is uncommon but potentially delay in diagnosis as it may mimic the presentation of primary post saccal nasolacrimal duct obstruction. In this article, we reported a case of primary non Hodgkin's lymphoma of the lacrimal sac presented with recurrent acute dacryocystitis in a young lady. A 28 years old Malay lady had history of persistent epiphora on left eye for 4 years. Prior to presentation to our clinic, it was preceded by progressive recurrent painful medial canthal swelling for 6 months duration. Clinical diagnosis of post saccal naso lacrimal duct obstruction was made and otorhinolaryngology assessment revealed intranasal mass. Endoscopic excision was done showed diffuse large B cell lymphoma on histology. The patient was started on 6 cycles of chemotherapy which subsequently result in no recurrence of the tumour post chemotherapy. Any case of post saccal nasolacrimal duct obstruction should be investigated thoroughly as it may become as a presentation of other sinister pathology.

Effect of mitomycin combined with Nd-YAG laser on cell proliferation and invasion as well as MEK/ERK signaling pathway in obstructive lacrimal duct model

Objective: To study the effect of mitomycin (MMC) combined with Nd-YAG laser on cell proliferation and invasion as well as MEK/ERK signaling pathway in obstructive lacrimal duct model. Methods: New Zealand rabbits were selected as experimental animals and divided into model group, laser group and MMC + laser group;obstructive lacrimal duct model was established, then laser group were given Nd-YAG laser intervention, and MMC + laser group were given Nd-YAG laser combined with mitomycin intervention. 2 months after intervention, the expression of proliferation molecules, invasion molecules and MEK-ERK signaling molecules in lacrimal duct tissue were measured. Results: TGF-β, CTGF, PCNA, Ki-67, Col-I, Col-III, MEK, ERK1/2, MMP2 and MMP9 protein levels in lacrimal duct tissue of laser group were significantly higher than those of model group while TSG-6, Cthrc1 and TIMP1 protein levels were significantly lower than those of model group;TGF-β, CTGF, PCNA, Ki-67, Col-I, Col-III, MEK, ERK1/2, MMP2 and MMP9 protein levels in lacrimal duct tissue of MMC + laser group were significantly lower than those of laser group while TSG-6, Cthrc1 and TIMP1 protein levels were significantly higher than those of laser group. Conclusion:Mitomycin can inhibit cell proliferation and invasion as well as MEK/ERK signaling pathway activation in obstructive lacrimal duct model after Nd-YAG laser treatment.

Comparison of scanning electron microscopy findings regarding biofilm colonization with microbiological results in nasolacrimal stents for external, endoscopic and transcanalicular dacryocystorhinostomy

AIM:To compare bacterial biofilm colonization in lacrimal stents following external dacryocystorhinostomy(EX-DCR),endoscopic dacryocystorhinostomy(EN-DCR),and transcanalicular dacryocystorhinostomy(TC-DCR)with multidiode laser.METHODS:This prospective study included 30consecutive patients with nasolacrimal duct obstruction who underwent EXT-,EN-,or TC-DCR.Thirty removed lacrimal stent fragments and conjunctival samples were cultured.The lacrimal stent biofilms were examined by scanning electron microscopy(SEM).RESULTS:Eleven(36.7%)of the 30 lacrimal stent cultures were positive for aerobic bacteria(most commonly Staphylococcus epidermidis and Pseudomonas aeruginosa).However anaerobic bacteria and fungi were not identified in the lacrimal stent cultures.Twenty-seven(90%)patients had biofilmpositive lacrimal stents.The conjunctival culture positivity after the DCR,biofilm positivity on stents,the grade of biofilm colonization,and the presence of mucus and coccoid and rod-shaped organisms did not significantly differ between any of the groups(P】0.05).However,a significant difference was found when the SEM results were compared to the results of the lacrimal stent and conjunctival cultures(P【0.001).CONCLUSION:Type of dacryocystorhinostomy(DCR)surgery did not affect the biofilm colonization of the lacrimal stents.SEM also appears to be more precise than microbiological culture for evaluating the presence of biofilms on lacrimal stents.

Endonasal Endoscopic Dacryocystorhinostomy with the Use of Radiofrequency (RF) Surgical Technique

Endonazal endoscopic dacryocystorhinostomy (DCR) with radiofrequency (RF) surgical technique is a procedure selected for nasolacrimal duct obstruction and chronic dacryostenosis in the setting of patent canaliculi and a functional lacrimal pump. Two major approaches are utilized: external, via a transcutaneous incision and endonasal endoscopically guided. The surgery has the high success rate via both approaches. We review the history, evolution, current techniques, complications and future directions of DCR radiofrequency RF operative technique. The modified endonasal RF-coagulation technique was performed in patients aged 18 - 85 (women-80, men-35) from 2017 to 2023. All patients suffered from chronic dacryocystitis. They had been administered the course of traditional conservative treatment and were provided with the ophthalmologist’s and otorhinolaryngology’s consultations prior to the surgery. In order to verify the diagnosis, the patients were conducted the CT-scan examination of nasal cavity and paranasal sinuses as well as the endoscopy of nasal cavity. Endonasal dacryocystorhinostomy with RF coagulator proved to be effective in 80% of patients;Over 3 - 4 years following the surgery, the recurrence was manifested in 8 patients after 6 months and in 12 patients, after a year. The above mentioned surgical treatment is administered by minimally invasive surgical method. At the same time, the long-term, for about 1 year, implantation of silicone drainage in the nasolacrimal ducts significantly reduces the risk of recurrence. At the present stage, the endoscopic Endo-DCR surgery is being improved, and the diverse treatment methods, including radiofrequency (RF) in endonasal endoscopic microsurgical techniques, are being studied and introduced into practice.

Pathological,immunohistochemical and microbiologicalal analysis of lacrimal sac biopsies in patients with chronic dacrocystitis

AIM:To analyze cases of obstruction of the nasolacrimal duct which creates a fertile environment for secondary bacterial Infection and can result in dacryocystitis,which is a constant threat to cornea and orbital soft tissue and a potential source of endophthalmitis following intraocular surgery.The majority of obstructions of the lacrimal excretory outflow system are acquired ones occurring in adulthood and involving the distal parts of the system.Acquired obstruction may be primary/idiopathic or secondary to a wide variety of infectious,inflammatory,traumatic,mechanical,toxic or neoplastic causes mimicking idiopathic inflammation.These cases are treated by dacryocystorhinostomy(DCR).METHODS:The present study was conducted to determine the histopathologic,immunohistochemical and current microbiologic characteristics of lacrimal sac specimens in patients undergoing external dacryocystorhinostomy.RESULTS:Non-specific lacrimal sac pathology was present in all 33 cases and 81.8%of the cases showed moderate chronic inflammation with a chronic inflammatory score(CIS)ranging between 4 and 6,whereas 12.12%showed severe inflammatory changes with a CIS of 7.Mild degree of inflammation was seen in6.06%with a CIS of 3.The total prevalence of grampositive,gram-negative,and culture-negative samples were 59.4%,37.5%,and 3%respectively.CONCLUSION:Non-specific chronic inflammation withfibrosis is indeed the most commonly reported histopathological finding in lacrimal sac wall biopsy specimens.

Computed tomography imaging features for amyloid dacryolith in the nasolacrimal excretory system:A case report

BACKGROUND Nasolacrimal duct obstruction leading to epiphora is a common ophthalmologic complaint,and it may derive from amyloidosis in rare cases.There are a few reports about localized amyloidosis,and amyloidosis with involvement and obstruction of the nasolacrimal duct is exceedingly rare.CASE SUMMARY A 54-year-old male presented with a 2-year history of a lump overlying the left lacrimal sac that had grown rapidly for nearly half a year.Physical examination touched a firm lump in the left lacrimal sac.Nasal endoscopy discovered lesions in appearance of sediments with easy bleeding at the entry of the nasolacrimal duct of the left inferior nasal meatus.Computerized tomography scan revealed speckle high density in the left lacrimal sac and the dilated nasolacrimal duct.During an endoscopic exploration and excision,a large number of dacryoliths were exposed.Pathology indicated amorphous pink material and multinucleated giant cell reaction in the fibrous tissue.CONCLUSION This case showed amyloidosis in localized form mimicking dacryolith with nasolacrimal duct obstruction.In clinical practice,we should be aware of the possibility of localized amyloidosis in the nasolacrimal excretory system.

Effects of medication methods after simple and effective probing of lacrimal passage

AIM:To evaluate the effect of reducing the use of antibiotics in the treatment of infant bacterial dacryocystitis after probing of the lacrimal duct.METHODS:A total of 542 cases of children under one year old and accepting nasolacrimal duct probing treatment were divided into two groups, which were treated with topical and oral antibiotics, respectively.Conjunctival sac secretions were used as a control index of bacterial infection, whereas the disappearance of epiphora symptoms and lacrimal passage patency were used as cure indexes. The χ2test was used to compare enumeration and measurement data, and a statistical significance was set at P 【0.05. The therapeutic effect on the two groups of postoperative patients was investigated.RESULTS:In the two study groups, no significant differences in gender, age and postoperative control of lacrimal sac infection were observed. The cure rates after three probing operations also showed no significant difference.CONCLUSION:After probing of the lacrimal passage,results of this study confirmed that postoperative medication without oral antibiotics but an ophthalmic dosage of antibiotics was a simple and effective treatment method.

基于骨性鼻泪管走向的逆行充气泪道CT造影三平面重组技术的初步研究

目的基于骨性鼻泪管走向的逆行充气泪道电子计算机断层扫描(CT)造影三平面重组技术,评估其检查泪囊前泪道阻塞患者的鼻泪管和泪囊通畅情况的准确性和安全性。方法纳入2022年10月—2023年12月的泪囊前泪道阻塞患者43例(57只眼),行充气前CT横轴位扫描,判断鼻泪管和泪囊空气存留情况。对充气前CT横轴位扫描鼻泪管和泪囊未充满空气的患者,使用自行设计制作的经鼻泪管下口逆行充气和气压监测系统使患者泪道充填空气,行CT横轴位扫描,并记录拍摄过程中最大鼓气气压值。对泪道CT横轴位扫描结果进行三维重建和以骨性鼻泪管走向的横轴位、冠状位和矢状位三平面重组分析其通畅情况,再与手术中探查结果对比,评估其准确性。同时观察并发症和不良反应,评估其安全性。结果(1)一般情况:逆行充气前,43例(57只眼)泪道阻塞患者中,泪囊及鼻泪管均充满空气有3例(4只眼),而空气未充满有40例(53只眼)。(2)逆行充气试验:逆行充气后,未完全充满空气的53只眼,鼻泪管和泪囊被气体均充满的33只眼,未见气体填充20只眼。术中验证33只眼的鼻泪管和泪囊均通畅,而20只眼中12只眼为鼻泪管下段真性阻塞,而8只眼鼻泪管无阻塞,该检查方法的灵敏度为80.4%,特异度为100.0%,准确率为84.9%。鼻腔鼓气的最佳气压值的参考范围为8~9 kPa。(3)并发症和不良反应:检查过程中及检查后均未见任何并发症和不良反应。结论基于骨性鼻泪管走向的逆行充气泪道CT造影三平面重组技术可以全程清晰显示双侧鼻泪管,有助于对于前泪囊阻塞患者的鼻泪管和泪囊通畅情况进行判断,安全性好,对临床治疗术式的选择有一定的指导意义。

鼻内镜下泪囊鼻腔造口术与泪道逆行置管术治疗鼻泪管阻塞的临床对比研究

目的 对比鼻内镜下泪囊鼻腔造口术与泪道逆行置管术治疗鼻泪管阻塞(NLDO)的临床效果。方法 50例鼻泪管阻塞患者,按就诊天数的单双号分为A组(单号日期, 25例)、B组(双号日期,25例)。A组实施鼻内镜下泪道逆行置管术, B组实施鼻内镜下泪囊鼻腔造口术。对比两组手术相关指标、并发症发生率、复发率。结果 A组手术时间(29.25±3.18)min、在院时间(0.85±0.23)d明显短于B组的(51.74±3.26)min、(4.47±1.26)d,出血量(5.03±1.06)ml少于B组的(46.45±11.12)ml(P<0.05)。A组并发症发生率(4.00%)低于B组(24.00%),但术后1年复发率(28.00%)高于B组(4.00%)(P<0.05)。结论 鼻内镜下泪道逆行置管术治疗鼻泪管阻塞较泪囊鼻腔造口术具有手术时间短、操作较容易、出血量少等优势,而鼻内镜下泪囊鼻腔造口术较泪道逆行置管术则更有利于预防术后复发。

鼻泪管支架植入术改善预后的研究进展

原发性鼻泪管阻塞通常表现为顽固性泪溢,可继发角膜炎、急慢性泪囊炎等影响眼部健康。鼻泪管支架植入为治疗该疾病的重要辅助方式,有效降低泪道探通、激光泪道成形、泪囊鼻腔吻合等术后膜性泪道再阻塞率。但术中机械损伤、术后持续的慢性炎症及瘢痕组织增生等问题仍会引起术后鼻泪管狭窄及再阻塞。文章就鼻泪管支架植入术再发性阻塞的发病机制及相应改善措施的前沿进展进行综述,为临床诊疗提供新思路。

泪道X线造影、鱼腥草滴眼液冲洗联合泪道探通术在治疗婴幼儿泪囊炎中的应用

目的探究泪道X线造影、鱼腥草滴眼液冲洗联合泪道探通术治疗婴幼儿泪囊炎的临床疗效。方法将2021年8月至2022年8月在保定市妇幼保健院接受治疗的200例患有泪囊炎的2个月~2岁婴幼儿纳入本次研究。按照随机数字表法将其分为观察组(n=100)和对照组(n=100)。对照组患儿接受泪道X线造影+泪道探通术治疗,观察组患儿接受X线造影+鱼腥草滴眼液冲洗+泪道探通术治疗。比较2组的临床疗效、1次探通成功率、治疗前后血清炎症因子[白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)和高敏C反应蛋白(hs-CRP)]水平、并发症发生情况及术后复发情况。结果观察组患儿的总有效率为92.00%,显著高于对照组(81.00%),差异有统计学意义(P<0.05)。观察组的1次探通成功率为94.00%,显著高于对照组(85.00%),差异有统计学意义(P<0.05)。治疗后,2组的血清IL-6、TNF-α和hs-CRP水平均较治疗前显著下降,且观察组治疗后的血清IL-6、TNF-α和hs-CRP水平分别为(2.49±0.77)pg/mL、(5.13±1.60)pg/mL、(10.63±2.39)mg/L,均显著低于对照组[(3.65±0.89)pg/mL、(6.01±1.75)pg/mL、(13.17±2.71)mg/L],差异均有统计学意义(P<0.05)。2组的总并发症发生率和复发率比较,差异均无统计学意义(P>0.05)。结论泪道X线造影+鱼腥草滴眼液冲洗+泪道探通术治疗婴幼儿泪囊炎的临床疗效良好,可显著提高1次探通成功率,降低炎症反应,且安全性良好,术后不易复发。

单眼内窥镜下鼻腔泪囊吻合术后双眼眼表指标的变化

目的:探讨单眼内窥镜下鼻腔泪囊吻合术对双眼眼表指标的影响。方法:纳入于2022-12-01/2023-07-31诊断为单眼原发性获得性鼻泪管阻塞(PANDO),并成功实施内窥镜下鼻腔泪囊吻合术的患者45例。收集术前,术后0.5、1、3 mo的眼表指标,包括平均非侵入性泪膜破裂时间(NIBUT)、干燥综合征国际合作临床联盟眼部染色评分(SICCA OSS)、眼睑刷Korb评分、非表面麻醉泪液分泌试验(Schirmer test)。对比手术前后术眼与健眼在各个时间点上的各项指标。结果:术眼和健眼NIBUT、SICCA OSS、Korb评分、Schirmer test无明显的组间差异(均P>0.05)。术眼术后0.5、1、3 mo的Korb评分明显低于术前(P=0.034、0.044、0.027)。术眼术后1 mo的Schirmer test明显低于手术前(P=0.0461)。结论:内窥镜下鼻腔泪囊吻合术后泪液引流恢复正常,眼表损伤加重,这些变化通常在术后约1 mo达到峰值,然后逐渐恢复。

鱼腥草滴眼液联合泪道探通术治疗泪道阻塞合并慢性泪囊炎患儿的效果

目的评估鱼腥草滴眼液联合泪道探通术对泪道阻塞合并慢性泪囊炎患儿的治疗效果。方法选择河北省保定市妇幼保健院2021年8月至2022年8月收治的196例泪道阻塞合并慢性泪囊炎患儿为研究对象,采用随机数字表法将患儿分为对照组和观察组,每组98例。对照组给予泪道探通术,观察组采用泪道探通术联合鱼腥草滴眼液冲洗。记录两组患儿的临床疗效,比较两组患儿治疗前和治疗3个月后的炎症因子水平、泪液分泌量、泪膜破裂时间、泪河高度、角膜荧光素染色(FLS)评分、睑板腺分泌状态,比较两组患儿出血、组织水肿、眼膜划伤等并发症发生率和家属满意度。结果观察组患儿的临床疗效优于对照组,差异有统计学意义(P<0.05)。治疗前,两组患儿炎症水平和眼部症状比较,差异无统计学意义(P>0.05)。治疗后,两组患儿炎症因子水平、FLS评分、眼睑板状态评分、泪液分泌量、泪河高度低于治疗前,且观察组低于对照组;两组患儿泪膜破裂时间长于治疗前,且观察组长于对照组,差异有统计学意义(P<0.05)。观察组患儿术后并发症发生率低于对照组,家属满意度优于对照组,差异有统计学意义(P<0.05)。结论泪道探通术联合鱼腥草滴眼液冲洗,能够降低患儿术后炎症因子水平、改善眼部症状,从而提高治疗效果。

两种不同治疗方法治疗婴幼儿泪囊炎的疗效对比分析

目的比较泪道探通术+鱼腥草滴眼液与泪道探通术+妥布霉素滴眼液冲洗治疗婴幼儿泪囊炎的疗效。方法将2021年8月至2022年8月在保定市妇幼保健院接受治疗的200例患有泪囊炎的2个月~2岁婴幼儿纳入本次前瞻性研究。按照随机数字表法将其分为鱼腥草组(n=100)和妥布霉素组(n=100)。鱼腥草组患儿接受泪道X线造影+鱼腥草滴眼液冲洗+泪道探通术治疗;妥布霉素组患儿接受泪道X线造影+妥布霉素滴眼液冲洗+泪道探通术治疗。比较两组的临床疗效、1次探通成功率、治疗前后血清炎症因子[白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)和高敏C反应蛋白(hs-CRP)]水平、并发症发生情况及术后复发情况。结果鱼腥草组和妥布霉素组的总有效率比较(90.00%vs.95.00%),差异无统计学意义(P>0.05)。鱼腥草组与妥布霉素组的1次探通成功率比较(91.00%vs.96.00%),差异无统计学意义(P>0.05)。治疗后,两组的血清IL-6、TNF-α和hs-CRP水平均较治疗前显著下降,差异均有统计学意义(P<0.05);鱼腥草组与妥布霉素组治疗后的血清IL-6、TNF-α和hs-CRP水平比较[(2.52±0.71)pg/mL vs.(2.39±0.65)pg/mL,(5.18±1.61)pg/mL vs.(5.05±1.57)pg/mL,(10.57±2.46)mg/L vs.(10.10±2.27)mg/L],差异均无统计学意义(P>0.05)。鱼腥草组与妥布霉素组的并发症发生率(7.00%vs.4.00%)和术后复发率(0 vs.0)比较,差异均无统计学意义(P>0.05)。结论鱼腥草滴眼液冲洗+泪道探通术治疗婴幼儿泪囊炎的临床疗效与妥布霉素滴眼液冲洗+泪道探通术相当,且安全性高,术后不易复发。

Nd:YAG泪道激光联合泪道引流管置入对泪道阻塞患者疗效及并发症的影响

目的:探讨Nd:YAG泪道激光联合泪道引流管置入对泪道阻塞患者疗效及并发症的影响。方法:选取2018年2月—2023年2月海安市中医院收治的102例泪道阻塞患者作为研究对象,采用随机数字表法分为对照组与观察组,各51例。对照组采用传统泪道重建手术治疗,观察组采用Nd:YAG泪道激光联合泪道引流管置入治疗,比较两组治疗总有效率、并发症发生率及眼表状态。结果:术后1个月,观察组治疗总效率显著高于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率显著低于对照组,差异有统计学意义(P<0.05)。两组术前及术后2个月的泪液分泌量、泪膜破裂时间比较,差异均无统计学意义(P>0.05)。结论:对泪道阻塞患者行Nd:YAG泪道激光联合泪道引流管置入治疗,能够显著提高患者的治疗有效率,降低并发症的发生率,并且不影响眼表状态。

泪道置管术治疗泪道狭窄或阻塞的临床效果

目的研究对泪道狭窄或阻塞患者实施泪道置管术治疗的效果。方法选取2022年1月—2022年12月本院收治的50例泪道狭窄或阻塞患者为研究对象,均给予泪道置管术治疗,对比治疗前后眼表症状和治疗效果。结果治疗后眼表症状评分显著低于治疗前(P<0.05)。治疗后OSDI、SF-36评分显著优于治疗前(P<0.05)。经过统计,治疗有效率达到96.00%,术后出现并发症共计10例(20.00%),均采取对应处理措施进行治疗。结论针对泪道狭窄或阻塞,采取泪道置管术可有效改善症状,取得良好的治疗效果,提高患者生活质量。术后,患者可能出现不同程度的并发症,经过处理治疗后均恢复健康。

鼻内镜下泪囊鼻腔吻合术治疗二种慢性泪囊炎的疗效分析

目的比较鼻内镜下泪囊鼻腔吻合术治疗单纯性慢性泪囊炎与泪道置管术后复发性泪囊炎的疗效观察。方法选取2016年4月至2020年4月于山西省运城市中心医院就诊的慢性泪囊炎病人100例,均选择单眼,共100只眼行回顾性分析;将所有病人分为两组:单纯组和复发组,各50例,50只眼;所有病人均行鼻内镜下泪囊鼻腔吻合术治疗,术后随访6个月,并分析病人术后的治疗效果。结果术后6月时单纯组的总有效率为92%,复发组的总有效率为76%,单纯组明显高于复发组,两组比较差异有统计学意义(Z=−2.17,P<0.05)。结论泪道置管术后复发性泪囊炎经鼻内镜下泪囊鼻腔吻合术治疗,其手术效果明显低于单纯性慢性泪囊炎。

内镜下泪囊鼻腔吻合术治疗急性泪囊炎急性发作期的疗效

目的评估内镜下泪囊鼻腔吻合术(En-DCR)治疗急性泪囊炎急性发作期的疗效。方法纳入2016年9月-2020年12月于温州医科大学附属眼视光医院行En-DCR的66例成年急性泪囊炎急性发作期(发作时间小于72 h)的患者。入院后常规静脉抗生素治疗,并在入院24 h内行En-DCR,术后静脉抗生素和激素治疗2 d。术后随访12个月,记录患者急性炎症消退时间(泪囊区肿胀消退、内眦部疼痛消退和皮肤红斑消退)、泪道再造术成功率和并发症发生率。结果En-DCR术后泪囊区肿胀消退时间1~5 d,平均(2.97±0.96)d;内眦部疼痛消退时间2~7 d,平均(3.79±1.31)d;内眦部皮肤红斑消退时间3~14 d,平均(6.98±3.59)d。术后12个月泪道再造术成功率为93.44%(57/61)。未出现急性泪囊炎复发、内眦部破溃、眶内脓肿和眶蜂窝织炎等并发症。结论对于成年急性泪囊炎的急性发作期即刻行En-DCR,效果好,术后成功率高,无皮肤破溃和感染扩散等并发症发生,值得临床推广应用。