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单泪小管和总泪小管阻塞行泪道穿刺后置入球囊行泪小管成形术

Ballooning canaliculoplasty after lacrimal trephination in monocanalicular and common canalicular obstruction.

作者信息

Yang Suk-Woo, Park Hae-Young, Kikkawa Don O

机构信息

Department of Ophthalmology and Visual Science, College of Medicine, Kangnam St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.

Division of Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology, Shiley Eye Center, University of California, San Diego, La Jolla, CA, USA.

出版信息

Jpn J Ophthalmol. 2008 Nov-Dec;52(6):444-449. doi: 10.1007/s10384-008-0598-7. Epub 2008 Dec 17.

Abstract

PURPOSE

To evaluate the clinical effect of balloon canaliculoplasty with LacriCATH after lacrimal trephination in monocanalicular and common canalicular obstruction.

METHODS

Silicone intubation following ballooning dilation with a 2-mm-diameter catheter after lacrimal trephination was attempted in 66 eyes of 62 patients (10 men, 52 women; mean age, 67.3 years; age range, 34-77 years) with epiphora due to monocanalicular or common canalicular obstruction between January 2003 and February 2005. A total of 56 of the 66 eyes had common canalicular obstruction, and ten had monocanalicular obstruction.

RESULTS

The cause of obstruction in 54 (81.8%) eyes was idiopathic. Overall initial technical improvement was achieved in 64 (97.0%) eyes (common canalicular obstruction, 56/56, 100%; monocanalicular obstruction, 8/10, 80.0%) Immediate clinical improvement was achieved in 54 eyes (81.8%). The cumulative patency rates at the last clinic visit were 53.6% in cases of common canalicular obstruction and 25.0% in cases of monocanalicular obstruction. Causes of failure were combined nasolacrimal duct obstruction, recurrent monocanalicular obstruction, and acute canaliculitis.

CONCLUSIONS

Balloon canaliculoplasty after lacrimal trephination is a simple and safe method that may be a good alternative treatment for common canalicular and distal canalicular obstructions, before resorting to conjunctivodacryorhinostomy with Jones tube insertion.

摘要

目的

评估泪道钻孔术后使用LcriCATH球囊泪小管成形术治疗单泪小管和泪总管阻塞的临床效果。

方法

2003年1月至2005年2月期间,对62例(男性10例,女性52例;平均年龄67.3岁,年龄范围34 - 77岁)因单泪小管或泪总管阻塞而溢泪的患者的66只眼睛,在泪道钻孔后尝试使用直径2毫米的导管进行球囊扩张,随后进行硅胶插管。66只眼中共有56只存在泪总管阻塞,10只存在单泪小管阻塞。

结果

54只(81.8%)眼睛的阻塞原因是特发性的。总体上,64只(97.0%)眼睛实现了初始技术改善(泪总管阻塞,56/56,100%;单泪小管阻塞,8/10,80.0%)。54只眼睛(81.8%)实现了即刻临床改善。在最后一次门诊随访时,泪总管阻塞病例的累积通畅率为53.6%,单泪小管阻塞病例的累积通畅率为25.0%。失败原因包括合并鼻泪管阻塞、复发性单泪小管阻塞和急性泪小管炎。

结论

泪道钻孔术后球囊泪小管成形术是一种简单且安全的方法,在采用Jones管插入的结膜泪囊鼻腔吻合术之前,可能是治疗泪总管和泪小管远端阻塞的良好替代治疗方法。

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