Mandour Sameh S, Said-Ahmed Khaled E, Khairy Hany A, Elsawy Moataz F, Zaky Marwa A
Department of Ophthalmology, Menoufia University, Faculty of Medicine, Shebin El Kom, Menoufia, Egypt.
J Ophthalmol. 2019 Jan 14;2019:3561857. doi: 10.1155/2019/3561857. eCollection 2019.
Evaluation of using pigtail probe to detect and open severely stenosed lower lacrimal punctum followed by self-retaining bicanalicular intubation.
A prospective nonrandomized clinical study.
The study included 24 patients with severe lower punctal stenosis (grade 0 according to Kashkouli scale) attending at Menoufia University Hospitals. The upper punctum and canaliculus were patent. All patients were complaining of epiphora and had a thorough ophthalmological examination including dye disappearance test and slit-lamp examination. Pigtail probe was used from patent upper punctum to detect the lower stenosed punctum which was opened with a scalpel. Syringing of the lower lacrimal passages was done to confirm its patency, and self-retaining silicone bicanalicular stent was inserted. The silicone tube was left in place for 6 months before it was removed. Patients were then followed-up for 1 year after the surgery.
One year after surgery, epiphora was absent (grade 0) in 16 eyes (66.7%) and was present only occasionally (grade 1) in 4 eyes (16.7%). The difference from preoperative epiphora was statistically significant. One year after surgery, fluorescein dye disappearance time was grade 1 (<3 minutes) in 20 cases (83.3%), and grade 2 (3-5 minutes) in 4 cases (16.7%). There was a statistically significant difference compared with preoperative results.
Using the pigtail probe is effective in treatment of severe punctal stenosis. Maintaining the punctal opening and prevention of restenosis can be achieved by using self-retaining bicanalicular stent after confirmation of nasolacrimal duct patency. This trial is registered with NCT03731143.
评估使用猪尾探针检测并打开严重狭窄的下泪小点，随后进行自固定式双泪小管插管的效果。
一项前瞻性非随机临床研究。
该研究纳入了24例在曼苏拉大学医院就诊的严重下泪小点狭窄患者（根据卡什库利量表为0级）。上泪小点和泪小管通畅。所有患者均有溢泪症状，并接受了全面的眼科检查，包括染料清除试验和裂隙灯检查。从通畅的上泪小点使用猪尾探针检测下狭窄的泪小点，并用手术刀将其打开。对下泪道进行冲洗以确认其通畅性，然后插入自固定式硅胶双泪小管支架。硅胶管留置6个月后取出。术后对患者进行1年的随访。
术后1年，16只眼（66.7%）溢泪消失（0级），4只眼（16.7%）仅偶尔出现溢泪（1级）。与术前溢泪情况相比，差异具有统计学意义。术后1年，20例（83.3%）荧光素染料清除时间为1级（<3分钟），4例（16.7%）为2级（3 - 5分钟）。与术前结果相比，差异具有统计学意义。
使用猪尾探针治疗严重泪小点狭窄有效。在确认鼻泪管通畅后，使用自固定式双泪小管支架可维持泪小点开放并预防再狭窄。本试验已在ClinicalTrials.gov注册，注册号为NCT03731143。
