Gonnering R S, Bosniak S L
Department of Ophthalmology, University of Wisconsin, Madison.
Ophthalmic Plast Reconstr Surg. 1989;5(1):27-33. doi: 10.1097/00002341-198903000-00004.
Eleven female and 4 male patients presented with 20 documented episodes of acute noninfectious dacryocystic retention. This syndrome complex consists of severe pain and tearing with minimal but tender distention of the lacrimal sac, without signs of inflammation. It is caused by impaction of a dacryolith in the nasolacrimal duct. In our group of patients, the mean age when seen was 39 +/- 14 years, and the mean onset of symptoms occurred at age 35 +/- 13 years. Six episodes resolved spontaneously, and the rest responded to interventional therapy. In six, irrigation relieved the symptoms. One patient each responded to probing, lacrimal intubation, and primary dacryocystorhinostomy (DCR). In three patients, a new technique of percutaneous nasolacrimal duct dilatation using angiographic techniques relieved symptoms. One patient each failed irrigation and percutaneous dilatation and required secondary DCR. Recognition of this presentation permits differentiation of this syndrome from infectious lacrimal obstruction and allows appropriate therapy. In at least some patients, percutaneous nasolacrimal duct dilatation may offer both a method of accurate diagnosis and an initial alternative to more extensive surgery.
11名女性患者和4名男性患者出现了20次有记录的急性非感染性泪囊潴留发作。这种综合征包括严重疼痛和流泪，泪囊仅有轻微但有压痛的肿胀，无炎症迹象。它是由鼻泪管内泪石嵌顿引起的。在我们的患者组中，就诊时的平均年龄为39±14岁，症状的平均发病年龄为35±13岁。6次发作自行缓解，其余患者对介入治疗有反应。6例患者经冲洗后症状缓解。分别有1例患者对探查、泪道插管和原发性泪囊鼻腔吻合术（DCR）有反应。3例患者采用血管造影技术经皮鼻泪管扩张的新技术缓解了症状。分别有1例患者冲洗和经皮扩张失败，需要二次DCR。认识到这种表现有助于将该综合征与感染性泪道阻塞区分开来，并允许进行适当的治疗。至少在一些患者中，经皮鼻泪管扩张术既可以提供一种准确的诊断方法，也是一种比更广泛手术更可取的初始替代方法。
