Wu Wenjie, Li Zhiwei, Yan Duan, Lin Yong, Xu Nuo
a Department of Ophthalmology, Fujian Provincial Hospital , Fujian Medical University , Fujian , PR China.
b Department of Ophthalmology and Otorhinolaryngology , Lianjiang Hospital , Fuzhou , Fujian , PR China.
Semin Ophthalmol. 2017;32(5):607-613. doi: 10.3109/08820538.2016.1139737. Epub 2016 Jul 1.
To evaluate the safety, efficacy, and outcomes of early bicanalicular silicone intubation in the treatment of acute purulent dacryocystitis.
This prospective interventional case series focused on acute purulent dacryocystitis from February 2010 to March 2014. Of the 21 cases, 16 cases were treated at the Fujian Provincial Hospital, and five cases were treated at the Lianjiang Hospital. Bicanalicular silicone intubation was inserted in the original lacrimal duct within 10 days after abscess decompression by pus aspiration method and systemic antibiotic application. Data collection included demographic profiles, perioperative and postoperative complications, and revision surgery. Resolution of signs and symptoms of acute purulent dacryocystitis, as well as successful anatomical patency assessed by irrigation, was evaluated. Follow-up times were more than 12 months, and ranged from 14 to 63 months.
All patients showed remarkable improvement of pain and swelling within 48 hours. Resolution of the erythema and edema was observed within one week after bicanalicular silicone intubation combined with topical antibiotic lavage. No intraoperative and postoperative complications were observed. After initial bicanalicular silicone intubation, anatomical success was observed in 66.7% (14/21) of the patients. Of the remaining seven patients who presented with severe reflux in irrigation, two patients chose re-intubation and five patients underwent standard external dacryocystorhinostomy. All patients had anatomical success at last follow-up.
Early bicanalicular silicone intubation appears to be a safe, effective, and simple procedure, which offers a reasonable option in the treatment of acute purulent dacryocystitis, especially for those developing and underdeveloped areas.
评估早期双泪小管硅胶插管术治疗急性化脓性泪囊炎的安全性、有效性及治疗效果。
本前瞻性干预性病例系列研究聚焦于2010年2月至2014年3月期间的急性化脓性泪囊炎。21例患者中，16例在福建省立医院接受治疗，5例在连江医院接受治疗。在采用脓液抽吸法进行脓肿减压并应用全身抗生素治疗后10天内，在原泪道插入双泪小管硅胶插管。数据收集包括人口统计学资料、围手术期和术后并发症以及再次手术情况。评估急性化脓性泪囊炎的体征和症状是否缓解，以及通过冲洗评估泪道是否成功实现解剖学通畅。随访时间超过12个月，范围为14至63个月。
所有患者在48小时内疼痛和肿胀均有显著改善。在双泪小管硅胶插管联合局部抗生素冲洗后一周内，观察到红斑和水肿消退。未观察到术中及术后并发症。首次双泪小管硅胶插管后，66.7%（14/21）的患者实现了解剖学成功。其余7例冲洗时出现严重反流的患者中，2例选择再次插管，5例行标准外路泪囊鼻腔吻合术。所有患者在最后一次随访时均实现了解剖学成功。
早期双泪小管硅胶插管术似乎是一种安全、有效且简单的手术方法，为急性化脓性泪囊炎的治疗提供了一种合理选择，尤其适用于那些发展中及欠发达地区。
