局部应用丝裂霉素在内镜辅助探查中治疗大龄儿童先天性鼻泪管阻塞
Topical mitomycin in endoscopic-assisted probing for the treatment of congenital nasolacrimal duct obstruction in older children.
作者信息
Galindo-Ferreiro Alicia, Khandekar Rajiv, Akaishi Patricia Mitiko, Cruz Antonio Augusto Velasco, Galvez-Ruiz Alberto, Dolmetsch Angela, Schellini Silvana Artioli
机构信息
King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
Department of Ophthalmology, Rio Hortega University Hospital, Valladolid, Spain
出版信息
Arq Bras Oftalmol. 2020 Jun;83(3):229-235. doi: 10.5935/0004-2749.20200062. Epub 2020 May 29.
PURPOSE
Mitomycin C has been used in ophthalmic surgery to mitigate postoperative scarring. However, the outcomes of endoscopic-assisted probing for the treatment of congenital nasolacrimal duct obstruction with adjunctive mitomycin C in children remain unknown. Our study was aimed to evaluate the efficacy and safety of adjunctive application of mitomycin C after endoscopic-assisted probing for the treatment of congenital nasolacrimal duct obstruction in children.
METHODS
This is a retrospective chart review performed in a tertiary eye care hospital involving children with congenital nasolacrimal duct obstruction, who underwent endoscopic-assisted probing from October 2013 to August 2015. We compared children who underwent endoscopic-assisted probing with mitomycin C (mitomycin C group) versus others who underwent endoscopic-assisted probing without mitomycin C (endoscopic-assisted probing group). The mitomycin C group received 0.2 mg/ml within 4 min to the nasolacrimal duct ostium using a cotton tip applicator immediately after probing. Probing was considered successful when patient complaints of tearing were reduced or the results of the dye disappearance test were normal. Demographic data, clinical features, and intraoperative and postoperative variables were correlated to the success rate.
RESULTS
The study sample comprised 68 lacrimal vies. The majority of children had bilateral obstruction and no previous history of probing. The mean age of the patients was approximately 4 years. Most obstructions were considered complex. The success rates were high in both groups (p>0.05). There were no adverse events related to the use of mitomycin C (p>0.05).
CONCLUSIONS
Although mitomycin C has no adverse effects when applied to the opening of the nasolacrimal duct, its use after lacrimal probing for the treatment of congenital nasolacrimal duct obstruction does not improve the chance of success.
目的
丝裂霉素C已被用于眼科手术以减轻术后瘢痕形成。然而，在儿童中，内镜辅助探通术联合丝裂霉素C治疗先天性鼻泪管阻塞的效果仍不明确。我们的研究旨在评估内镜辅助探通术联合丝裂霉素C治疗儿童先天性鼻泪管阻塞的有效性和安全性。
方法
这是一项在三级眼科护理医院进行的回顾性病历研究，纳入了2013年10月至2015年8月期间接受内镜辅助探通术的先天性鼻泪管阻塞患儿。我们比较了接受内镜辅助探通术联合丝裂霉素C的患儿（丝裂霉素C组）和接受单纯内镜辅助探通术的患儿（内镜辅助探通组）。丝裂霉素C组在探通术后立即使用棉棒将0.2mg/ml的丝裂霉素C注入鼻泪管开口处，持续4分钟。当患者流泪症状减轻或染料消失试验结果正常时，探通被认为成功。人口统计学数据、临床特征以及术中术后变量与成功率相关。
结果
研究样本包括68只泪腺。大多数患儿为双侧阻塞，且既往无探通史。患儿的平均年龄约为4岁。大多数阻塞被认为是复杂的。两组的成功率都很高（p>0.05）。未发生与使用丝裂霉素C相关的不良事件（p>0.05）。
结论
虽然丝裂霉素C应用于鼻泪管开口处时无不良反应，但其在泪道探通术后用于治疗先天性鼻泪管阻塞并不能提高成功几率。
Zotero 插件