Dotan Gad, Ohana Oded, Leibovitch Igal, Stolovitch Chaim
Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Maccabi Healthcare Services, Ramat Hasharon, Israel.
Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Int J Pediatr Otorhinolaryngol. 2015 Mar;79(3):301-4. doi: 10.1016/j.ijporl.2014.09.027. Epub 2014 Oct 5.
To study predictors and implications on outcome of premature silicone tube-loss, a post-operative complication of monocanalicular intubation (MCI) performed for treatment of congenital nasolacrimal duct obstruction (CNLDO).
We conducted a retrospective analysis of cases of post-operative loss of monocanalicular silicone tubes occurring at one medical center from January 2007 to December 2013.
During the study period monocanclicular silicone tubes were lost in 24/54 eyes (44%) of 19/46 children. Multivariate regression analysis identified bilateral intubation as an important predictor of early tube-loss (r=0.54, P=0.006). Seven of eight (88%) children who had both eyes intubated prematurely lost their tubes compared to 12/38 (32%) children who had unilateral intubation (P=0.005). Treatment success was lower in eyes with early tube-loss (17/24 eyes, 71%) compared to eyes with full tube retention (25/30 eyes, 83%), however this difference was not statistically significant (P=0.333). In our study, treatment outcome correlated with duration of intubation (r=0.51, P=0.002). Surgical success was achieved in 33/39 eyes (85%) in which the tubes were retained at least 2 months compared to 7/15 eyes (47%) with shorter period of intubation (P=0.012).
Spontaneous tube-loss is a post-operative complication of monocanalicular silicone intubation that can occur more frequently than previously reported in certain populations. Tube-loss occurring soon after surgery is often associated with persistent symptoms and increased need of reoperation.
研究先天性鼻泪管阻塞（CNLDO）单泪小管插管术（MCI）术后过早出现硅胶管丢失这一并发症的预测因素及其对治疗结果的影响。
我们对2007年1月至2013年12月在某医疗中心发生的单泪小管硅胶管术后丢失病例进行了回顾性分析。
在研究期间，19/46名儿童的24/54只眼（44%）出现了单泪小管硅胶管丢失。多因素回归分析确定双侧插管是早期管丢失的一个重要预测因素（r = 0.54，P = 0.006）。8名双眼过早插管的儿童中有7名（88%）出现了管丢失，而单侧插管的儿童中为12/38（32%）（P = 0.005）。早期管丢失的眼治疗成功率（17/24只眼，71%）低于管完全保留的眼（25/30只眼，83%），然而这种差异无统计学意义（P = 0.333）。在我们的研究中，治疗结果与插管持续时间相关（r = 0.51，P = 0.002）。与插管时间较短的7/15只眼（47%）相比，插管至少2个月的33/39只眼（85%）实现了手术成功（P = 0.012）。
硅胶管自发丢失是单泪小管硅胶插管术后的一种并发症，在某些人群中发生频率可能比之前报道的更高。术后不久出现的管丢失常伴有持续症状且再次手术需求增加。
