Zhang Yi, Fan Yu, Fan Jinlu, Cui Yanhui
1 Department of Ophthalmology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China.
2 Department of Lacrimal Duct, Nanjing Aier Eye Hospital, Nanjing, China.
Eur J Ophthalmol. 2019 Mar;29(2):158-164. doi: 10.1177/1120672118785276. Epub 2018 Jul 12.
: To evaluate the surgical intervention and its effect on congenital dacryocystocele.
: A total of 531 children with congenital dacryocystocele admitted to the Department of Ophthalmology of Beijing Children's Hospital, Shanghai Aier Eye Hospital, Nanjing Aier Eye Hospital, and the First Affiliated Hospital of Jinzhou Medical University between January 2007 and January 2017 were retrospectively analyzed.
: A total of 531 patients were followed up for 3-24 months, with an average of 13.3 months. No serious intraoperative complications (such as bleeding and tissue damage) and postoperative complications (bleeding, infection, and hole atresia) were found. We classified the outcomes into three categories based on the signs (overflowing tears and empyema) and objective routine follow-up by endoscopy. Cure indicated that mass, overflow of tears, and breathing difficulties disappeared, and 81.5% cases (433/531) were postoperatively cured. Improvement indicated disappearance of mass, overflow empyema, and the presence of residual tears (due to trocar and tears puncture), and 18.5% cases (98/531) were postoperatively improved. Unhealed indicated overflowing pus and tears, and 0% cases did not heal after surgery.
: Nasal endoscopic surgery is relatively safe, with high success rate for treatment of congenital dacryocystocele. Systematic training is required to promote the application of nasal endoscopy, so that more ophthalmologists can learn this technique.
评估手术干预及其对先天性泪囊膨出的疗效。
回顾性分析2007年1月至2017年1月期间在北京儿童医院眼科、上海爱尔眼科医院、南京爱尔眼科医院及锦州医科大学附属第一医院收治的531例先天性泪囊膨出患儿。
共531例患者接受了3至24个月的随访，平均随访时间为13.3个月。未发现严重的术中并发症（如出血和组织损伤）及术后并发症（出血、感染和泪道闭锁）。根据体征（溢泪和积脓）及鼻内镜检查的客观常规随访情况，将结果分为三类。治愈表示肿块、溢泪及呼吸困难消失，术后治愈的病例占81.5%（433/531）。好转表示肿块、积脓消失，但仍有残留泪液（因穿刺针及泪小点穿刺所致），术后好转的病例占18.5%（98/531）。未愈合表示仍有脓性及泪液溢出，术后无未愈合病例。
鼻内镜手术相对安全，治疗先天性泪囊膨出成功率高。需要进行系统培训以推广鼻内镜的应用，使更多眼科医生能够掌握此项技术。
