Forno Eliana, Buzalaf Flavio
Divisão de Clínica Oftalmológica, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP.
Arq Bras Oftalmol. 2005 Mar-Apr;68(2):199-203. doi: 10.1590/s0004-27492005000200009. Epub 2005 May 18.
To demonstrate the efficacy and possible complications of a surgical technique that includes the removal of the vertical portion of the lacrimal canaliculus in patients with dry eye syndrome.
A study was performed on six canaliculi of six eyes (four patients). Three patients had dry eye, associated with primary Sjögren syndrome. One of the four patients developed keratoconjuntivitis sicca due to lacrimal gland removal. The criteria included: patients with symptoms of dry eye that did not improve even with the continuous use of artificial tears, low results (less than 5 mm) with the Schirmer test, rose bengal staining and cases of recanalization after thermal occlusion with electrocauterium. The lacrimal puncta were examined after 7, 15, 30, 60, 90 and 180 days after surgery.
None of the canaliculus recanalized at this time. Punctate keratitis, corneal filaments, Schirmer and rose bengal tests improved in 5 eyes. Diffuse punctate keratitis was present in the patient with lacrimal gland removal even 2 months after of surgery. Eyelid margin complications were not observed.
This technique is simple and effective in permanent lacrimal canaliculus occlusion. We did not note any complications compared to other procedures.
证明一种手术技术的疗效及可能出现的并发症，该技术包括切除干眼症患者泪小管的垂直部分。
对6只眼（4例患者）的6条泪小管进行了研究。3例患者患有干眼症，与原发性干燥综合征相关。4例患者中有1例因泪腺切除而发生角结膜干燥症。纳入标准包括：即使持续使用人工泪液干眼症状仍未改善的患者、泪液分泌试验结果低（小于5毫米）、孟加拉玫瑰红染色以及电烙热闭塞后再通的病例。术后7、15、30、60、90和180天对泪点进行检查。
此时无泪小管再通。5只眼中点状角膜炎、角膜丝状物、泪液分泌试验和孟加拉玫瑰红试验有所改善。即使在手术后2个月，泪腺切除的患者仍存在弥漫性点状角膜炎。未观察到睑缘并发症。
该技术在永久性泪小管闭塞方面简单有效。与其他手术相比，我们未发现任何并发症。
