Steinsapir K D, Glatt H J, Putterman A M
Department of Ophthalmology and Visual Sciences, University of Chicago, IL.
Am J Ophthalmol. 1990 Apr 15;109(4):387-93. doi: 10.1016/s0002-9394(14)74603-3.
We reviewed a consecutive series of 79 conjunctival dacryocystorhinostomies performed over a 16-year period in 75 patients. Thirty-eight of 75 patients with canalicular blockage between the common canaliculus and the first 5 mm of the canaliculus as well as patients with common canalicular blockage who had failed previous dacryocystorhinostomy were treated with combined canalicular reconstruction, nasal lacrimal intubation, and conjunctival dacryocystorhinostomy. In 37 patients, less than 5 mm of proximal canaliculus remained open. These patients were treated with conjunctival dacryocystorhinostomy alone, including four patients who had bilateral procedures. Two of 38 patients who underwent combined canalicular and conjunctival procedures required further surgery for a successful outcome compared with 14 of 37 patients who underwent conjunctival dacryocystorhinostomy without canalicular reconstruction (P = .002). Overall, 71 of 74 patients (96%) had a successful outcome, and five patients were lost to follow-up.
我们回顾了在16年期间对75例患者施行的连续79例结膜泪囊鼻腔吻合术。75例患者中，38例泪小管阻塞发生于泪总管与泪小管起始部5mm之间，以及既往泪囊鼻腔吻合术失败的泪总管阻塞患者，接受了泪小管重建、鼻泪管插管及结膜泪囊鼻腔吻合术联合治疗。37例患者近端泪小管开放长度不足5mm，这些患者仅接受了结膜泪囊鼻腔吻合术治疗，其中4例接受了双侧手术。接受泪小管与结膜联合手术的38例患者中有2例需要进一步手术才能获得成功，而未进行泪小管重建仅接受结膜泪囊鼻腔吻合术的37例患者中有14例需要进一步手术（P = .002）。总体而言，74例患者中有71例（96%）治疗成功，5例患者失访。
