Emmerich K-H, Amin S, Meyer-Rüsenberg H-W, Ungerechts R
Klinik für Augenheilkunde, Klinikum Darmstadt GmbH, Heidelberger Landstr. 379, 64297, Darmstadt, Deutschland.
Augenklinik der Universität Witten/Herdecke, St. Josefs-Hospital Hagen, Witten/Herdecke, Deutschland.
Ophthalmologe. 2017 May;114(5):409-415. doi: 10.1007/s00347-017-0481-3.
Lacrimation of the eye is a relatively common problem, the cause of which must be clarified by differential diagnostics. The most important symptom of a dysfunction of lacrimal drainage is epiphora.
Due to the enhancement and miniaturization of endoscopes, which were originally used in gastroduodenoscopy in the 1990s, it is possible to check the anatomical structure and visualize pathological changes of the lacrimal drainage system, which is only approximately 1 mm in diameter. As shown by the results, mechanical stenoses are often caused by recurrent chronic inflammation. A complete stenosis usually occurs only slowly due to dysregulation of the lacrimal unit.
In contrast to the assumptions that were valid before the implementation of microendoscopy, complete stenoses are often only punctate and do not stretch over long distances. Shortly after the introduction of microendoscopic diagnostics minimally invasive therapy techniques, such as laser dacryoplasty (LDP) and microdrill dacryoplasty (MDP) were established. These procedures have enabled for the first time preservation of the entire physiology of the lacrimal drainage pump system despite surgical intervention after recanalization.
眼部流泪是一个相对常见的问题,其病因必须通过鉴别诊断来明确。泪液引流功能障碍的最重要症状是溢泪。
由于20世纪90年代最初用于胃十二指肠镜检查的内窥镜的改进和小型化,现在可以检查直径仅约1毫米的泪液引流系统的解剖结构并观察其病理变化。结果表明,机械性狭窄通常由复发性慢性炎症引起。由于泪液单位调节异常,完全狭窄通常只会缓慢发生。
与微内窥镜检查实施之前的假设相反,完全狭窄通常只是点状的,不会延伸很长距离。在引入微内窥镜诊断后不久,就建立了激光泪道成形术(LDP)和微钻泪道成形术(MDP)等微创治疗技术。尽管在再通后进行了手术干预,但这些手术首次实现了泪液引流泵系统整个生理功能的保留。