Mimura Masashi, Oku Hidehiro, Ueki Mari, Sato Bunpei, Ikeda Tsunehiko
Department of Ophthalmology, Osaka Medical College, Takatsuki City, Osaka, Japan.
Department of Ophthalmology, Osaka Kaisei Hospital, Osaka City, Osaka, Japan.
Am J Ophthalmol Case Rep. 2018 May 22;11:41-44. doi: 10.1016/j.ajoc.2018.05.005. eCollection 2018 Sep.
To report a case of prolonged placement of a lacrimal silicone tube for 20 years, with evaluation of the lacrimal duct using lacrimal micro-endoscopy and inspection of deformation of the lacrimal tube.
This study involved a case of dacryocystitis in which a silicone tube had been placed in the patient 20-years previous and that was treated conservatively. Although granulation tissue formation due to dacryocystitis in the lacrimal duct was observed under lacrimal micro-endoscopy, subjective and objective resolution of symptoms, including granulated tissue formation, was achieved after removal of the silicone tube and conservative medical treatment. Follow-up examinations performed over a 12-month period post treatment revealed no recurrence of epiphora or anatomical obstruction. Inspection of the lacrimal tube using the tension test revealed minimal changes in the tube for 20 years.
The findings in this case suggest both the lacrimal system and the silicone tube are tolerant to prolonged intubation, as long as the tube had been placed properly with careful observation. Our findings may encourage physicians to consider prolonged intubation for select cases of nasolacrimal duct obstruction.
报告一例泪道硅胶管留置20年的病例，并使用泪道显微内镜评估泪道以及检查泪管变形情况。
本研究涉及一例泪囊炎患者，该患者20年前曾植入硅胶管，此次采用保守治疗。尽管在泪道显微内镜下观察到泪道因泪囊炎形成了肉芽组织，但在取出硅胶管并进行保守药物治疗后，包括肉芽组织形成在内的症状在主观和客观上均得到缓解。治疗后12个月的随访检查显示，未出现溢泪复发或解剖学阻塞。通过张力测试检查泪管发现，20年来泪管变化极小。
该病例的研究结果表明，只要泪管放置得当并仔细观察，泪道系统和硅胶管均可耐受长时间插管。我们的研究结果可能会鼓励医生在某些鼻泪管阻塞病例中考虑延长插管时间。
