Orbital Plastic and Lacrimal Clinic, Royal Victorian Eye and Ear Hospital, Melbourne, Australia.
Ophthalmic Plast Reconstr Surg. 2009 Sep-Oct;25(5):346-9. doi: 10.1097/IOP.0b013e3181b1e512.
To report lacrimal drainage obstruction in association with inflammatory bowel disease (IBD) in 9 patients.
The clinical records of 461 consecutive adult patients treated for acquired lacrimal obstruction by dacryocystorhinostomy were reviewed. Patients with IBD were identified. Additional data collected included known secondary causes of lacrimal obstruction, a history of sinonasal disease, complications following lacrimal surgery, and demographic information.
Nine patients (7 women, 2 men) with a median presenting age of 61 years (range, 38-70 years) had IBD. Five patients had Crohn disease, and 4 patients had ulcerative colitis. Seven patients had nasolacrimal duct stenosis or obstruction, and 2 patients had lacrimal canalicular obstruction. Six patients (67%) reported symptoms of sinonasal disease. One patient reported intermittent tearing and nasal obstructive symptoms during flare-ups of bowel disease. All 9 patients were being treated with long-term oral 5-aminosalicylate agents prior to the onset of lacrimal symptoms. One patient had recurrent lacrimal obstruction, 1 year after initially successful surgery. No other surgical complications were observed. Excluding 1 patient with herpetic canalicular obstruction and Crohn disease, the proportion of patients undergoing dacryocystorhinostomy surgery identified to have IBD (1.7%) was significantly higher than the estimated prevalence of IBD in the Australian population (0.3%) (p < 0.0001).
In a large cohort of patients surgically treated for acquired lacrimal obstruction, the authors found an increased rate of IBD compared with the estimated population prevalence. To investigate this association further, the authors recommend obtaining lacrimal sac biopsies from patients with IBD who undergo dacryocystorhinostomy surgery.
报告 9 例与炎症性肠病（IBD）相关的泪道阻塞。
回顾了 461 例连续成人患者因获得性泪道阻塞而行鼻内泪囊吻合术的临床记录。确定了患有 IBD 的患者。收集的其他数据包括已知的泪道阻塞的继发性原因、鼻-鼻窦疾病史、泪道手术后的并发症以及人口统计学信息。
9 例（7 例女性，2 例男性）患者的中位发病年龄为 61 岁（范围为 38-70 岁），患有 IBD。5 例为克罗恩病，4 例为溃疡性结肠炎。7 例有鼻泪管狭窄或阻塞，2 例有泪小管阻塞。6 例（67%）患者报告有鼻-鼻窦疾病症状。1 例患者在肠道疾病发作期间报告间歇性流泪和鼻塞症状。所有 9 例患者在出现泪道症状前均长期口服 5-氨基水杨酸制剂。1 例患者在初次成功手术后 1 年内再次发生泪道阻塞。未观察到其他手术并发症。排除 1 例疱疹性泪小管阻塞和克罗恩病患者后，行鼻内泪囊吻合术的患者中被确定患有 IBD（1.7%）的比例明显高于澳大利亚人群中估计的 IBD 患病率（0.3%）（p<0.0001）。
在接受手术治疗获得性泪道阻塞的大量患者中，作者发现与估计的人群患病率相比，IBD 的发生率增加。为了进一步研究这种相关性，作者建议对接受鼻内泪囊吻合术的患有 IBD 的患者进行泪囊活检。
