Zhuang Ai, Jin Xiaoliang, Li Yinwei, Fan Xianqun, Shi Wodong
Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
Medicine (Baltimore). 2017 Aug;96(33):e7814. doi: 10.1097/MD.0000000000007814.
This report is to explore the long-term outcomes of surgical repair of bicanalicular lacerations in Chinese preschool patients. In this report, 12 patients with bicanalicular lacerations were studied between September 2010 and September 2015. The distance from the punctum to the distal canalicular lacerated end was recorded before surgery to classify different types of trauma. All patients underwent surgical repair of the lacerated canaliculi by 1 surgeon within 48 hours after the trauma occurred. After treatment, the lesions were divided into 3 types according to the distance from the punctum to the distal lacerated canalicular end as follows: lateral, medial, and the central. Based on this classification, each lacerated canaliculus was successfully repaired. Nearly half of the lesions (46%) were lateral, 42% were central, and 12% were medial. The average time for locating the proximal lacerated end of the canaliculus was 3.33 ± 1.52 minutes (range, 1.0-7.0 minutes). The follow-up time ranged from 6.0 months to 4.5 year (median, 25 months). Our study showed that 96% (23) of the canaliculi were completely patent. One lateral lesion presented with residual outdoor epiphora in cold weather secondary to left lower canalicular stenosis. All 12 patients had excellent cosmetic results. Our study displayed a surgical management based on the 3 types of lesions helped to find the proximal lacerated end of the canaliculus, and provided excellent long-term outcomes of drainage function.
本报告旨在探讨中国学龄前患者双泪小管撕裂伤手术修复的长期疗效。在本报告中，对2010年9月至2015年9月期间的12例双泪小管撕裂伤患者进行了研究。术前记录泪点至远端泪小管撕裂端的距离，以对不同类型的创伤进行分类。所有患者均在创伤发生后48小时内由1名外科医生对撕裂的泪小管进行手术修复。治疗后，根据泪点至远端撕裂泪小管端的距离将病变分为3种类型：外侧型、内侧型和中央型。基于这种分类，每条撕裂的泪小管均成功修复。近一半的病变（46%）为外侧型，42%为中央型，12%为内侧型。找到泪小管近端撕裂端的平均时间为3.33±1.52分钟（范围为1.0 - 7.0分钟）。随访时间为6.0个月至4.5年（中位数为25个月）。我们的研究表明，96%（23条）的泪小管完全通畅。1例外侧型病变因左下泪小管狭窄在寒冷天气出现残留的溢泪。所有12例患者的美容效果均极佳。我们的研究表明，基于3种病变类型的手术管理有助于找到泪小管近端撕裂端，并提供了良好的引流功能长期疗效。
