Rajabi Mohammad Taher, Abrishami Yalda, Hosseini Seyedeh Simindokht, Tabatabaee Syed Ziaeddin, Rajabi Mohammad Bagher, Hurwitz Jeffrey J
J Pediatr Ophthalmol Strabismus. 2014 Nov-Dec;51(6):360-2. doi: 10.3928/01913913-20140909-02. Epub 2014 Sep 16.
To investigate the clinical outcomes of late primary probing in congenital nasolacrimal duct (NLD) obstruction.
A prospective interventional study was designed to recruit children older than 24 months who presented with clinical manifestations of NLD obstruction since February 2008 to Farabi Eye Hospital, Tehran, Iran. No prior surgical intervention for NLD obstruction was performed on these patients; they underwent probing of the nasolacrimal system and irrigation under general anesthesia by oculoplastic surgeons. The outcome of the procedure was assessed 2 to 3 months postoperatively. Data of the patients until February 2013 were considered for analysis.
The total number of patients during the 5-year study was 343. The total success rate considering all of the age groups was 75.8%. The success rate was 85% in those who were 2 to 3 years old, 63% in those who were 3 to 4 years old, and 50% in those who were 4 to 5 years old. In patients with chronic dacryocystitis with mucopurulent discharge, 83% had successful probing and irrigation. In patients with epiphora with no mucopurulent discharge, 59% had successful results with probing.
In the cases of congenital NLD obstruction, primary probing before 2 years of age has a high success rate; there is a high overall success rate (75.8%) in the 2- to 5-years age group, but when older than 5 years, further procedures such as intubation and dacryocystorhinostomy would be needed because of the high failure rate of probing.
探讨先天性鼻泪管阻塞晚期初次探通术的临床疗效。
设计一项前瞻性干预性研究,纳入自2008年2月起至伊朗德黑兰法拉比眼科医院就诊、年龄超过24个月且有鼻泪管阻塞临床表现的儿童。这些患者此前未接受过鼻泪管阻塞的手术干预;他们在全身麻醉下由眼科整形医生进行鼻泪系统探通和冲洗。术后2至3个月评估手术效果。分析截至2013年2月的患者数据。
5年研究期间患者总数为343例。所有年龄组的总成功率为75.8%。2至3岁患者的成功率为85%,3至4岁患者为63%,4至5岁患者为50%。有黏液脓性分泌物的慢性泪囊炎患者中,83%探通和冲洗成功。无黏液脓性分泌物的溢泪患者中,59%探通结果成功。
对于先天性鼻泪管阻塞病例,2岁前初次探通成功率高;2至5岁年龄组总体成功率较高(75.8%),但5岁以上患者因探通失败率高,需要进一步进行插管和泪囊鼻腔吻合术等手术。