Khatib Lama, Nazemzadeh Maryam, Revere Karen, Katowitz William R, Katowitz James A
The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Rostami Oculofacial Plastic Consultants and Sanctuary Cosmetic Center, McLean, Virginia.
J AAPOS. 2017 Oct;21(5):380-383. doi: 10.1016/j.jaapos.2017.05.033. Epub 2017 Sep 14.
The Masterka stent has been recommended solely for treatment of simple distal membranous nasolacrimal duct obstruction (NLDO). The purpose of this study was to evaluate the Masterka stent as a primary treatment in complex forms of NLDO, including bony ductal stenosis and proximal and serial membranous obstruction.
The medical records of patients who underwent treatment for congenital nasolacrimal duct obstruction with the monocanalicular Masterka stent were reviewed retrospectively. Both simple and complex forms of NLDO were primarily treated with probing and irrigation, followed by placement of the Masterka stent.
A total of 72 eyes (53 patients) were included: 17 cases were simple forms of NLDO; and 55 were complex. Success was achieved in 15 of 17 simple cases (88%) and 39 of 55 complex cases (71%); the overall success rate was 75%. In patients <24 months of age, success rates were 100% for simple and 78% for complex forms.
The Masterka stent can be useful in a younger subset of patients with more complex forms of congenital NLDO. A lower success rate is noted in children >2 years of age and complex forms of NLDO, especially those with bony stenosis.
Masterka支架一直仅被推荐用于治疗单纯性远端膜性鼻泪管阻塞(NLDO)。本研究的目的是评估Masterka支架作为复杂形式NLDO的主要治疗方法,包括骨性导管狭窄以及近端和连续性膜性阻塞。
回顾性分析接受单泪小管Masterka支架治疗先天性鼻泪管阻塞患者的病历。单纯性和复杂性NLDO均首先进行探查和冲洗,然后置入Masterka支架。
共纳入72只眼(53例患者):17例为单纯性NLDO;55例为复杂性NLDO。17例单纯性病例中有15例(88%)成功,55例复杂性病例中有39例(71%)成功;总体成功率为75%。在年龄<24个月的患者中,单纯性病例成功率为100%,复杂性病例成功率为78%。
Masterka支架对患有更复杂形式先天性NLDO的较年轻患者亚组可能有用。在2岁以上儿童以及复杂性NLDO患者中成功率较低,尤其是那些伴有骨性狭窄的患者。