Oztürk Sertaç, Konuk Onur, Ilgit Erhan T, Unal Mehmet, Erdem Ozlem
Department of Ophthalmology, Gazi University Medical School, Ankara, Turkey.
Ophthalmic Plast Reconstr Surg. 2004 Mar;20(2):130-5. doi: 10.1097/01.iop.0000115597.92546.d5.
To evaluate the results of nasolacrimal polyurethane stent implantation for the treatment of primary acquired nasolacrimal duct obstruction and the effects of obstructed nasolacrimal stent on subsequent dacryocystorhinostomy (DCR).
This study was designed as a nonrandomized, prospective clinical trial. Stent implantation was attempted in 53 obstructed lacrimal drainage systems of 47 patients. Stent placement was performed in a retrograde fashion through the external nare over a guide wire, which was introduced from the upper punctum. Occluded stents were removed either with nasal endoscopy or during DCR. External DCR surgery with silicone intubation was performed in cases with stent failure.
The mean follow-up period was 23.4 months. The success rate of stent implantation was 60.4%, 37.5%, and 31.2% at 6-, 12-, and 18-month follow-up, respectively. Stent obstruction developed in 33 eyes. Twenty underwent external DCR with silicone intubation. During DCR surgery, varying degrees of chronic inflammatory reaction were detected in the lacrimal sac and nasolacrimal duct. The mean follow-up period after DCR was 10.3 months. Epiphora was relieved with DCR in all but one eye.
The success rate of nasolacrimal polyurethane stent implantation for the treatment of primary acquired nasolacrimal duct obstruction is low and may induce inflammation and fibrous tissue formation. Although this may cause further difficulties in subsequent lacrimal surgery, epiphora could be relieved with meticulous technique.
评估鼻泪管聚氨酯支架植入术治疗原发性后天性鼻泪管阻塞的效果以及阻塞性鼻泪管支架对后续泪囊鼻腔吻合术（DCR）的影响。
本研究设计为非随机前瞻性临床试验。对47例患者的53个阻塞性泪道系统尝试进行支架植入。通过从上方泪点插入的导丝，经外鼻孔逆行进行支架置入。阻塞的支架通过鼻内镜或在泪囊鼻腔吻合术中取出。支架植入失败的病例则进行带硅胶插管的外路泪囊鼻腔吻合术。
平均随访期为23.4个月。在6个月、12个月和18个月的随访中，支架植入成功率分别为60.4%、37.5%和31.2%。33只眼发生支架阻塞。20只眼接受了带硅胶插管的外路泪囊鼻腔吻合术。在泪囊鼻腔吻合术中，在泪囊和鼻泪管中检测到不同程度的慢性炎症反应。泪囊鼻腔吻合术后的平均随访期为10.3个月。除1只眼外，泪囊鼻腔吻合术使所有患者的溢泪症状得到缓解。
鼻泪管聚氨酯支架植入术治疗原发性后天性鼻泪管阻塞的成功率较低，且可能诱发炎症和纤维组织形成。虽然这可能给后续泪道手术带来进一步困难，但通过精细的手术技术可缓解溢泪症状。
