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眼睑裂伤中单管型义管的应用:美国眼科学会报告。

Monocanalicular Stents in Eyelid Lacerations: A Report by the American Academy of Ophthalmology.

机构信息

Ophthalmic Plastic Surgery, Lions Eye Institute, Department of Ophthalmology, Albany Medical Center, Albany (Slingerlands), New York.

Illinois Eye and Ear Infirmary, University of Illinois College of Medicine at Chicago, Chicago, Illinois.

出版信息

Ophthalmology. 2019 Sep;126(9):1324-1329. doi: 10.1016/j.ophtha.2019.03.045. Epub 2019 Apr 4.

Abstract

PURPOSE

To determine the efficacy and complication rates of monocanalicular stents in the setting of canalicular lacerations.

METHODS

A literature search was performed in May 2018 in the PubMed database to identify all English-language reports of monocanalicular stenting to address canalicular lacerations. Studies that did not include at least 10 patients with at least 3 months of follow-up evaluation after surgery were excluded. Ninety-nine articles were identified, and 15 of these met criteria for data abstraction and were included in this assessment. The panel methodologist (V.K.A.) evaluated the quality of evidence and assigned a level-of-evidence rating to each of these studies.

RESULTS

All 15 studies were rated as level III evidence. Anatomic and functional success rates after surgery ranged from 68% to 100% and 79% to 100%, respectively. Stents were generally well tolerated, although extrusion rates varied from 0% to 29%.

CONCLUSIONS

Only level III evidence was available, and studies were not powered to detect differences between groups for rare complications or failure. Monocanalicular stents seem to be efficacious and well tolerated in the management of canalicular lacerations. Potential complications include extrusion (most commonly), tube displacement, granuloma, ectropion, slit punctum, fistula, and infection. Further comparative studies would help to identify the optimal time for device removal and to directly compare monocanalicular with bicanalicular stents.

摘要

目的

确定在泪小管撕裂的情况下使用单通道支架的疗效和并发症发生率。

方法

2018 年 5 月,我们在 PubMed 数据库中进行了文献检索,以确定所有关于使用单通道支架治疗泪小管撕裂的英文报告。排除了未包括至少 10 例患者且术后至少 3 个月随访评估的研究。确定了 99 篇文章,其中 15 篇符合数据提取标准,并纳入本评估。小组方法学家(V.K.A.)评估了证据质量,并为这些研究中的每一项分配了证据级别评分。

结果

所有 15 项研究均被评为 III 级证据。术后解剖和功能成功率分别为 68%至 100%和 79%至 100%。支架通常耐受性良好,尽管脱出率为 0%至 29%。

结论

仅提供了 III 级证据,并且研究没有足够的能力来检测罕见并发症或失败的组间差异。单通道支架似乎在治疗泪小管撕裂方面是有效且耐受良好的。潜在的并发症包括脱出(最常见)、管移位、肉芽肿、外翻、裂孔穿刺、瘘管和感染。进一步的比较研究将有助于确定去除装置的最佳时间,并直接比较单通道和双通道支架。

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