Limbu Ben, Lyons Hannah S, Shrestha Mohan Krishna, Tabin Geoffrey C, Saiju Rohit
Tilganga Institute Of Ophthalmology, Gaushala, Kathmandu.
Nepal J Ophthalmol. 2019 Jan;11(21):24-28. doi: 10.3126/nepjoph.v11i1.254013.
The first line treatment for nasolacrimal duct obstruction (NLDO) is external dacrocystorhinostomy (DCR). Following DCR, patients are required to return to Tilganga Institute of Ophthalmology (TIO) six weeks postoperatively for the removal of a silicone stent. As the majority of patients travel large distances at significant cost to reach TIO, most often patients remain within Kathmandu during this six weeks interval. This places a large financial burden on patients.
A randomized controlled trial was designed to compare patient outcomes after early (two weeks postoperatively) versus standard (six weeks postoperatively) removal of silicone stents. 50 selected patients were randomized into two equal groups.
At the time of publication, 31 patients (14 in group A and 17 in group B) had completed three months follow up. A success rate of 92.9% was noted in Group A and a success rate of 94.1% observed in group B. No significant difference was found between the two groups for success rate and rate of complications.
Early tube removal post DCR appears to cause no significant difference in outcome or complication rates compared to standard tube removal.
鼻泪管阻塞（NLDO）的一线治疗方法是外部泪囊鼻腔吻合术（DCR）。DCR术后，患者需要在术后六周返回蒂尔甘加眼科研究所（TIO）取出硅胶支架。由于大多数患者要花费高昂成本长途跋涉才能到达TIO，所以在这六周的间隔期，大多数患者会留在加德满都。这给患者带来了巨大的经济负担。
设计了一项随机对照试验，比较早期（术后两周）与标准（术后六周）取出硅胶支架后的患者结局。50名选定患者被随机分为两组，每组人数相等。
在发表时，31名患者（A组14名，B组17名）完成了三个月的随访。A组成功率为92.9%，B组成功率为94.1%。两组在成功率和并发症发生率方面未发现显著差异。
与标准拔管相比，DCR术后早期拔管在结局或并发症发生率方面似乎没有显著差异。
