Beato João, Mota Ágata, Gonçalves Nuno, Santos-Silva Renato, Magalhães Augusto, Breda Jorge, Falcão-Reis Fernando
J Pediatr Ophthalmol Strabismus. 2017 Mar 1;54(2):123-127. doi: 10.3928/01913913-20161013-02. Epub 2016 Dec 16.
To report the success rate of children undergoing probing for congenital nasolacrimal duct obstruction (CNLDO) and the factors relating to the failure of the procedure.
This retrospective case series included 88 eyes of 62 patients, aged 1 to 138 months, who underwent probing between January 2008 and December 2014 in the Pediatric Ophthalmology Unit of Centro Hospitalar São João. The procedure was performed in the operating room under general anesthesia. Surgical success was defined as successful lacrimal irrigation in-traoperatively and resolution of epiphora at the follow-up visit 1 month after surgery.
The overall success rate after first probing was 77.3% (68 of 88 eyes). No differences were found regarding age (P = .546), gender (P = .740), surgical experience (P = .611), or laterality (P = .328) between children who were cured and not cured. The surgical success rate decreased in children older than 4 years, although not to a statistically significant degree (P = .190). Surgical success after second probing was 85.7% (12 of 14 eyes), and the median interval between the two procedures was 3 months (range: 2 to 54 months). In 30% (7 of 20 eyes, 4 of 13 patients) of children with persistent obstruction, otorhinolaryngology evaluation evinced an adenoid hypertrophy requiring surgical correction.
The success rate of nasolacrimal probing for CNLDO was not related to age, gender, laterality, or the surgeon's experience. Otorhinolaryngology evaluation is recommended for unresponsive patients. [J Pediatr Ophthalmol Strabismus. 2017;54(2):123-127.].
报告先天性鼻泪管阻塞(CNLDO)患儿泪道探通术的成功率及与手术失败相关的因素。
本回顾性病例系列研究纳入了2008年1月至2014年12月在圣若昂中心医院儿科眼科接受泪道探通术的62例患者的88只眼,年龄为1至138个月。手术在手术室全身麻醉下进行。手术成功定义为术中泪道冲洗成功且术后1个月随访时溢泪症状消失。
首次探通术后的总体成功率为77.3%(88只眼中的68只)。治愈和未治愈的儿童在年龄(P = 0.546)、性别(P = 0.740)、手术经验(P = 0.611)或患侧(P = 0.328)方面均未发现差异。4岁以上儿童的手术成功率有所下降,尽管未达到统计学显著程度(P = 0.190)。第二次探通术后的手术成功率为85.7%(14只眼中的12只),两次手术之间的中位间隔时间为3个月(范围:2至54个月)。在持续阻塞的儿童中,30%(20只眼中的7只,13例患者中的4例)经耳鼻喉科评估显示腺样体肥大需要手术矫正。
CNLDO泪道探通术的成功率与年龄、性别、患侧或外科医生的经验无关。对于无反应的患者,建议进行耳鼻喉科评估。[《小儿眼科与斜视杂志》。2017;54(2):123 - 127。]