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使用钟渊泪液引流管进行双泪小管插管治疗泪道近端狭窄

Bicanalicular Intubation with the Kaneka Lacriflow for Proximal Lacrimal Drainage System Stenosis.

作者信息

DeParis Sarah W, Hougen Clarinda J, Rajaii Fatemeh, Mahoney Nicholas R

机构信息

Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD, USA.

Department of Ophthalmology, The Permanente Medical Group, San Rafael, CA, USA.

出版信息

Clin Ophthalmol. 2020 Mar 23;14:915-920. doi: 10.2147/OPTH.S248423. eCollection 2020.

Abstract

PURPOSE

The Kaneka Lacriflow CL (Lacriflow) bicanalicular lacrimal intubation system was evaluated as a self-retaining alternative to traditional modalities for stenting and dilation of the lacrimal drainage system in proximal lacrimal drainage system stenosis.

PATIENTS AND METHODS

A retrospective chart review was conducted to assess the use of the Lacriflow system for treatment of patients with punctal and canalicular stenosis. Anesthesia type, operative time, and complications were assessed.

RESULTS

In the time period evaluated, a total of 72 Lacriflow stents were placed in 45 patients, most commonly under intravenous sedation. Stents were left in place for a mean of 145 days, with 9 stents left in place for more than 1 year, and a mean follow-up time of 263 days. Early complications within 90 days included prolapse in 1 stent, symptomatic colonization for 2 stents, and corneal abrasion in 1 stent in a patient with anterior basement membrane dystrophy. Five additional stents developed colonization in the late postoperative period (four of which were more than 1 year after stent placement). The overall complication rate (per stent) at 3 months after surgery was 5.6% and at all follow-up time points was 13.9%. Operative times were significantly shorter for a cohort of patients undergoing bicanalicular intubation with the Ritleng system ( = 0.015).

CONCLUSION

The Lacriflow bicanalicular stent can be easily placed without general anesthesia. Complication rates are comparable to other bicanalicular intubation systems, but increase with longer time that stents are left in place.

摘要

目的

评估Kaneka Lacriflow CL(泪道引流管)双泪小管泪道插管系统作为一种自固定替代方法,用于近端泪道系统狭窄时泪道引流系统的支架置入和扩张。

患者和方法

进行一项回顾性病历审查,以评估Lacriflow系统在治疗泪点和泪小管狭窄患者中的应用。评估麻醉类型、手术时间和并发症。

结果

在评估期间,共45例患者置入72个Lacriflow支架,最常见的是在静脉镇静下进行。支架平均留置145天,9个支架留置超过1年,平均随访时间为263天。90天内的早期并发症包括1个支架脱垂、2个支架出现有症状的定植,以及1例患有前部基底膜营养不良患者的1个支架出现角膜擦伤。另外5个支架在术后晚期出现定植(其中4个是在支架置入后1年以上)。术后3个月时总的并发症发生率(每个支架)为5.6%,在所有随访时间点为13.9%。与使用Ritleng系统进行双泪小管插管的一组患者相比,手术时间显著缩短(P = 0.015)。

结论

Lacriflow双泪小管支架无需全身麻醉即可轻松置入。并发症发生率与其他双泪小管插管系统相当,但随着支架留置时间延长而增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/296c/7125358/8172caee8d69/OPTH-14-915-g0001.jpg

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