Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
Graefes Arch Clin Exp Ophthalmol. 2012 Oct;250(10):1515-9. doi: 10.1007/s00417-012-2081-x. Epub 2012 Jun 17.
The aim of this work is to investigate the prevalence and clinical characteristics of congenital lacrimal fistula in Down syndrome patients.
The medical records of 198 Down syndrome patients who were referred to a tertiary ophthalmology clinic from 2000 to 2010 were retrospectively reviewed to identify patients with congenital lacrimal fistula. The demographic data, clinical features, clinical management, and clinical outcomes were recorded. The main outcome measures were the presence and laterality of fistula, accompanying adnexal and oculomotor abnormalities including congenital nasolacrimal duct obstruction (NLDO), the type of surgery performed, and surgical outcome. The prevalence of congenital lacrimal fistula in Down syndrome patients was calculated upon this data.
Congenital lacrimal fistula was identified in 8/198 (4.04 %) patients, 4 (2.02 %) of whom presented with bilateral lacrimal fistula. All patients that had lacrimal fistula complained of tearing from their eyes. Congenital NLDO was observed in seven of eight patients with lacrimal fistula. Five patients underwent excision of the lacrimal fistula for the improvement of cosmesis, and three of these patients also underwent lacrimal silicone intubation for NLDO. Another patient received lacrimal silicone intubation for NLDO without excision of the lacrimal fistula. Excision of the lacrimal fistula was successful in all patients; however, tearing persisted after surgery in two patients with uncorrected NLDO.
Congenital lacrimal fistula occurs more frequently in Down syndrome patients and therefore these patients should be thoroughly examined for this abnormality. Down syndrome patients with congenital lacrimal fistula should be also examined for NLDO, because this condition is frequently observed in these patients.
本研究旨在探讨唐氏综合征患者先天性泪囊瘘的患病率及临床特征。
回顾性分析 2000 年至 2010 年期间 198 例转诊至三级眼科诊所的唐氏综合征患者的病历资料，以确定先天性泪囊瘘患者。记录患者的人口统计学资料、临床特征、临床处理及临床结局。主要结局指标为瘘管的存在和位置、伴随的附属器和眼运动异常（包括先天性鼻泪管阻塞）、实施的手术类型及手术结局。根据这些数据计算唐氏综合征患者先天性泪囊瘘的患病率。
8/198（4.04%）例患者发现先天性泪囊瘘，其中 4 例（2.02%）为双侧瘘管。所有存在泪囊瘘的患者均主诉溢泪。8 例存在泪囊瘘的患者中，7 例存在先天性鼻泪管阻塞。5 例患者因美容需求接受了泪囊瘘切除术，其中 3 例同时接受了泪道硅胶管置入术治疗鼻泪管阻塞。另 1 例患者仅接受了泪道硅胶管置入术，未切除泪囊瘘。所有患者的泪囊瘘切除术均成功，但未矫正的鼻泪管阻塞导致 2 例患者术后仍有溢泪。
唐氏综合征患者先天性泪囊瘘的发生率较高，因此应对这些患者进行彻底检查。存在先天性泪囊瘘的唐氏综合征患者还应检查是否存在鼻泪管阻塞，因为这种情况在这些患者中经常发生。
