Stucki Vera C, Demolli Pashija, Kniestedt Christoph, Frimmel Sonja
Department of Ophthalmology, University Hospital Zürich, Zürich, Switzerland.
TAZZ, Talacker Augen Zentrum Zürich, Zürich, Switzerland.
Klin Monbl Augenheilkd. 2018 Apr;235(4):392-397. doi: 10.1055/s-0043-122672. Epub 2018 Feb 28.
Canaliculitis is often misdiagnosed. There are several conservative and surgical treatment options.
Retrospective analysis of 14 canaliculotomies in 10 patients with canaliculitis. The overall length of the surgically induced opening was measured and compared to the corresponding untreated lacrimal punctae. Lacrimal duct concrements were liberated and sent for microbiological and histological analysis. Patient satisfaction and relief of symptoms were documented as well as clinical findings.
Mean age was 59 ± 10 years (36 - 73 years) with balanced gender distribution. Mean follow-up time was 13 ± 8 months (4 - 27 months). Canaliculotomy was performed on 12 out of 14 inflamed canaliculi; in 2 cases, 3-snip punctoplasty was sufficient. The surgically induced length of the cuts was 1.7 ± 0.9 mm (0.4 - 3.7 mm). In 13 out of 14 cases, macroscopic concrements were found intraoperatively and actinomyces was verified histologically. Nine patients were free of symptoms postoperatively, and one patient manifested markedly less epiphora.
The canaliculi remained open within the long-term follow-up period without any drawbacks to the lacrimal outflow. No recurrent infections were seen.
泪小管炎常被误诊。有多种保守和手术治疗选择。
对10例泪小管炎患者的14次泪小管切开术进行回顾性分析。测量手术造成的开口总长度，并与相应未治疗的泪点进行比较。取出泪道结石并送去进行微生物学和组织学分析。记录患者满意度、症状缓解情况以及临床检查结果。
平均年龄为59±10岁（36 - 73岁），性别分布均衡。平均随访时间为13±8个月（4 - 27个月）。14条发炎的泪小管中有12条进行了泪小管切开术；2例中，3次剪断泪点成形术就足够了。手术造成的切口长度为1.7±0.9毫米（0.4 - 3.7毫米）。14例中有13例在术中发现肉眼可见的结石，组织学检查证实为放线菌。9例患者术后无症状，1例患者溢泪明显减轻。
在长期随访期间，泪小管保持开放，泪液流出无任何缺陷。未见复发性感染。
