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二极管激光辅助鼻泪管吻合术:一项前瞻性研究。

Diode Laser-Assisted Endocanalicular Dacryocystorhinostomy: A Prospective Study.

作者信息

Schlachter Dianne M, Richani Karina, Black Evan H

机构信息

*Wayne State University School of Medicine, Kresge Eye Institute, Detroit, Michigan; †Oakland University William Beaumont School of Medicine, Rochester, Michigan; ‡Consultants in Ophthalmic and Facial Plastic Surgery, PC, Southfield, Michigan; §Robert Cizik Eye Clinic, Houston, Texas; and ‖Ruiz Department of Ophthalmology and Visual Science, The University of Texas Medical School at Houston, Houston, Texas, U.S.A.

出版信息

Ophthalmic Plast Reconstr Surg. 2016 May-Jun;32(3):183-6. doi: 10.1097/IOP.0000000000000453.

Abstract

PURPOSE

To evaluate the efficacy of the diode laser in endocanalicular dacryocystorhinostomy.

METHODS

A prospective, noncomparative, interventional case series using the diode laser for endocanalicular dacryocystorhinostomy in patients with tearing and nasolacrimal duct obstruction. Outcome measures included subjective tearing complaints and objective patency of the nasolacrimal system. Success was defined as improvement of symptoms with patency of nasolacrimal drainage. Patients were followed for 12 months. Institutional review board approval was obtained.

RESULTS

Forty eyes (28 unilateral, 6 bilateral) underwent surgery. Five cases were excluded because of inadequate follow-up. Patients ranged in age from 27 to 88 years (66.7 ± 15.7). Seventy-seven percent were female and 23% were male. At 1 week, 88% had improvement in tearing, 12% had no change or worsening of symptoms, and all patients were patent on irrigation. At 1 month, 86% had improvement, 14% had no change, and all patients were patent on irrigation. At 3 months, 83% had improvement and were patent on irrigation. Seventeen percent had no change or worsening with reflux and were considered failures. At 6 months, 77% had improvement and were patent on irrigation. Five additional patients had no change, reflux on exam and were failed surgeries. At 12 months, 74% had complete resolution and were patent. One additional patient failed. Nine surgeries in 35 cases were considered failures by 12 months.

CONCLUSIONS

Subjective complaints of tearing correlated with patency of the nasolacrimal system after 3 months. A success rate of 74.3% (26 out of 35 cases) was observed by 12 months.

摘要

目的

评估二极管激光在内眦泪囊鼻腔吻合术中的疗效。

方法

一项前瞻性、非对照、干预性病例系列研究,对有流泪症状和鼻泪管阻塞的患者使用二极管激光进行内眦泪囊鼻腔吻合术。观察指标包括主观流泪症状和鼻泪系统的客观通畅情况。成功定义为症状改善且鼻泪引流通畅。对患者进行12个月的随访。获得了机构审查委员会的批准。

结果

40只眼(28只单侧,6只双侧)接受了手术。5例因随访不充分被排除。患者年龄在27至88岁之间(66.7±15.7)。77%为女性,23%为男性。术后1周,88%的患者流泪症状改善,12%的患者症状无变化或加重,所有患者冲洗通畅。术后1个月,86%的患者症状改善,14%的患者症状无变化,所有患者冲洗通畅。术后3个月,83%的患者症状改善且冲洗通畅。17%的患者症状无变化或加重且有反流,被视为手术失败。术后6个月,77%的患者症状改善且冲洗通畅。另有5例患者症状无变化,检查时有反流,手术失败。术后12个月,74%的患者症状完全缓解且冲洗通畅。又有1例患者手术失败。35例中有9例手术在12个月时被视为失败。

结论

3个月后流泪的主观症状与鼻泪系统的通畅情况相关。到12个月时,观察到成功率为74.3%(35例中的26例)。

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