Andalib Dima, Nabei Reza
Department of Oculoplasty and Strabismus, Nikookari Eye Hospital, Tabriz University of Medical Sciences, Abbasi St., Tabriz, Iran.
Eur J Ophthalmol. 2013 May-Jun;23(3):329-32. doi: 10.5301/ejo.5000175. Epub 2012 Nov 19.
To evaluate the intraoperative prognostic factors for probing outcome in children with congenital nasolacrimal duct obstruction (CNLDO).
In a prospective interventional study, 69 eyes of 60 children aged 12 to 24 months with CNLDO underwent probing and irrigation. All procedures were performed by a single oculoplastic surgeon. The nature of the obstruction was classified by the surgeon as simple or complex. The fluency of irrigation after probing was defined as easy or difficult. Treatment success was defined as no epiphora or mucus discharge at 3 months after probing.
The mean age at the time of probing was 15.3±3.1 months (range, 12-23 months). Treatment success was achieved in 56 of 69 eyes (81.2%). There was a significant difference in success rate of probing in eyes with simple obstruction (87.8%) compared with complex obstruction (65%) (p=0.02). Also, there was a significant difference in success rate of probing in eyes with easy irrigation (100%) compared with difficult irrigation (53.6%) (p<0.001).
Probing was more successful in eyes with simple obstruction or easy irrigation in children aged 12 to 24 months. The fluency of irrigation as an objective finding was a reliable intraoperative prognostic factor for probing success.
评估先天性鼻泪管阻塞(CNLDO)患儿探通术预后的术中相关因素。
在一项前瞻性干预性研究中,60例年龄在12至24个月的CNLDO患儿的69只眼睛接受了探通和冲洗。所有手术均由一名眼整形医生完成。手术医生将阻塞的性质分为简单型或复杂型。探通后冲洗的流畅程度分为容易或困难。治疗成功定义为探通术后3个月无溢泪或黏液排出。
探通时的平均年龄为15.3±3.1个月(范围12 - 23个月)。69只眼中有56只(81.2%)治疗成功。简单阻塞型眼睛的探通成功率(87.8%)与复杂阻塞型眼睛(65%)相比有显著差异(p = 0.02)。此外,冲洗容易的眼睛探通成功率(100%)与冲洗困难的眼睛(53.6%)相比有显著差异(p < 0.001)。
对于12至24个月的儿童,简单阻塞型或冲洗容易的眼睛探通术更易成功。冲洗的流畅程度作为一个客观发现,是探通成功的一个可靠的术中预后因素。