Al-Faky Yasser H, Al-Sobaie Nora, Mousa Ahmad, Al-Odan Hessa, Al-Huthail Reem, Osman Essam, Al-Mosallam Abdul Rahman
Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
J AAPOS. 2012 Feb;16(1):53-7. doi: 10.1016/j.jaapos.2011.07.020.
To evaluate the success rates of probing and silicone intubation and risk factors for failure of these procedures.
This retrospective cohort study included patients who were diagnosed with congenital nasolacrimal duct obstruction (NLDO) and underwent probing or intubation as the primary procedure. Demographic data, clinical features, intraoperative, and postoperative data were evaluated. The patients were divided into four subgroups based on age: 12-24 months, 25-36 months, 37-48 months, and >48 months. The procedure was considered successful when all preoperative signs disappeared with normal dye disappearance test and a positive Jones primary dye test. Statistical analysis was performed to determine the risk factors for failure, and P < 0.05 was statistically significant.
The cohort comprised 350 subjects (162 males [46%]) who underwent a total of 454 nasolacrimal duct surgeries. The mean chronological age at time of surgery was 32.6 ± 22.1 months (range, 12-132 months). The overall success rate was 84.8%. Probing was performed 188 times, with a success rate of 80.3%; intubation was performed 266 times, with a success rate of 88%.
Intubation was more successful than probing in patients with bilateral congenital nasolacrimal duct obstruction, Down syndrome, history of acute dacryocystitis, lack of preoperative massage, or intraoperative observation of either a "tight" obstruction or obstruction at sites other than at the level of Hasner's valve. Primary nasolacrimal duct intubation should be considered in these higher risk patients.
评估泪道探通术和硅胶管植入术的成功率以及这些手术失败的危险因素。
这项回顾性队列研究纳入了被诊断为先天性鼻泪管阻塞（NLDO）并接受泪道探通术或硅胶管植入术作为主要治疗手段的患者。对人口统计学数据、临床特征、术中及术后数据进行评估。根据年龄将患者分为四个亚组：12 - 24个月、25 - 36个月、37 - 48个月和>48个月。当所有术前体征消失且染料消失试验正常、琼斯氏初次染料试验呈阳性时，该手术被视为成功。进行统计分析以确定失败的危险因素，P < 0.05具有统计学意义。
该队列包括350名受试者（162名男性[46%]），共接受了454次鼻泪管手术。手术时的平均实际年龄为32.6 ± 22.1个月（范围，12 - 132个月）。总体成功率为84.8%。泪道探通术进行了188次，成功率为80.3%；硅胶管植入术进行了266次，成功率为88%。
在患有双侧先天性鼻泪管阻塞、唐氏综合征、急性泪囊炎病史、术前未进行按摩或术中观察到“紧密”阻塞或阻塞部位不在哈氏瓣膜水平的患者中，硅胶管植入术比泪道探通术更成功。对于这些高风险患者，应考虑进行原发性鼻泪管硅胶管植入术。
