Piaton J M, Keller P, Limon S, Quenot S
Centre National d'Ophtalmologie des Quinze-Vingts, Service du professeur S. Limon, 28, Rue de Charenton, 75012 Paris, France.
J Fr Ophtalmol. 2001 Mar;24(3):265-73.
To assess the efficacy of transcanalicular dacryocystorhinostomy for the revision of other procedures. The results are analyzed following the use of two different types of laser: the Neodymium: YAG (Nd: YAG) laser and the Holmium: YAG (Ho: YAG) laser. To study the efficacy of using two antimetabolite drugs in this context: mytomycin-C (MMC) and 5-fluoro-uracile (5-FU).
One hundred and fourteen patients were operated on. Of these, 88 had already undergone one procedure, 25 two procedures, and 5 three procedures. The Nd: YAG laser was used in 78 procedures, the Ho: YAG in 30 procedures, and both lasers in 10 procedures. Twenty patients were treated with an application of MMC and 25 patients with an application of 5-FU.
The results are based on 106 procedures. The total success rate was 49.06% after one revision and 58.49% after two or three revisions. There is no statistically significant difference between the Nd: YAG and Ho: YAG lasers. The use of antimetabolites did not improve the success rate.
Transcanalicular dacryocystorhinostomy is a very useful method because it does not cause cutaneous scarring and it has a low rate of morbidity given that it causes very little surgical traumatism. The revision of other dacryocystorhinostomy methods using the transcanalicular approach is theoretically a positive indication because it does not dissect scarring tissues and because the osteotomy has already been performed. However, the success rate is lower than for the external and endonasal approaches. The success rate is not modified by the use of antimetabolites or by the type of laser.
评估经泪小管泪囊鼻腔吻合术用于其他手术修复的疗效。分析使用两种不同类型激光（钕：钇铝石榴石（Nd：YAG）激光和钬：钇铝石榴石（Ho：YAG）激光）后的结果。研究在此背景下使用两种抗代谢药物（丝裂霉素 - C（MMC）和5 - 氟尿嘧啶（5 - FU））的疗效。
对114例患者进行了手术。其中，88例已接受过一次手术，25例接受过两次手术，5例接受过三次手术。78例手术使用Nd：YAG激光，30例使用Ho：YAG激光，10例手术两种激光都使用。20例患者使用MMC治疗，25例患者使用5 - FU治疗。
结果基于106例手术。一次修复后的总成功率为49.06%，两次或三次修复后的成功率为58.49%。Nd：YAG激光和Ho：YAG激光之间无统计学显著差异。抗代谢药物的使用并未提高成功率。
经泪小管泪囊鼻腔吻合术是一种非常有用的方法，因为它不会导致皮肤瘢痕形成，且由于手术创伤极小，发病率较低。从理论上讲，使用经泪小管入路修复其他泪囊鼻腔吻合术方法是一个积极的适应证，因为它不会切开瘢痕组织且已经进行了截骨术。然而，其成功率低于外部入路和鼻内入路。抗代谢药物的使用或激光类型不会改变成功率。
