Chu Yen-Chang, Wu Shu-Ya, Tsai Yueh-Ju, Liao Yi-Lin, Chu Hsueh-Yen
Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan; Chang Gung University, Taoyuan, Taiwan.
Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan; Chang Gung University, Taoyuan, Taiwan.
Am J Ophthalmol. 2017 Oct;182:155-159. doi: 10.1016/j.ajo.2017.08.006. Epub 2017 Aug 24.
To determine whether delayed repair of traumatic canalicular laceration affects the final outcome.
Retrospective case series.
The medical records of 334 patients who underwent primary traumatic canalicular laceration repair were retrospectively reviewed. Patients were divided into 2 groups according to the surgical timing within 48 hours (early) or after 48 hours (delayed). The anatomic results were compared between these 2 groups. The causes of delayed repair and the mean operation time were also analyzed.
There were 23 failed cases among 301 patients (7.6%) who had a repair within 48 hours and 3 failed cases among 33 patients (9.1%) who had a repair after 48 hours (P = .732). The mean operation time was 62 minutes in the early group and 66.3 minutes in the delayed group, which showed no significant difference (P = .371). The major cause of delayed surgery was traumatic brain injury, followed by facial or orbital fracture, long bone fracture, and chest injury.
Delayed canalicular repair in unstable patients did not lead to poor results. An elective scheduling surgery, instead of an urgent repair, is feasible for an experienced surgeon.
确定外伤性泪小管撕裂伤延迟修复是否会影响最终结果。
回顾性病例系列研究。
回顾性分析334例行原发性外伤性泪小管撕裂伤修复患者的病历。根据手术时机将患者分为两组，48小时内（早期）或48小时后（延迟）。比较两组的解剖学结果。分析延迟修复的原因及平均手术时间。
48小时内修复的301例患者中有23例失败（7.6%），48小时后修复的33例患者中有3例失败（9.1%）（P = 0.732）。早期组平均手术时间为62分钟，延迟组为66.3分钟，差异无统计学意义（P = 0.371）。延迟手术的主要原因是创伤性脑损伤，其次是面部或眼眶骨折、长骨骨折和胸部损伤。
不稳定患者延迟泪小管修复不会导致不良结果。对于经验丰富的外科医生来说，择期安排手术而非紧急修复是可行的。
