Li Lanjian, Lai Zhaoguang, Huang Wei, Xu Fan, Wu Yu
Department of Ophthalmology, People's Hospital of Guangxi Zhuang Autonomous Region.
Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.
Medicine (Baltimore). 2020 Nov 6;99(45):e23073. doi: 10.1097/MD.0000000000023073.
Contracture of dacryocyst by an implanted lacrimal silicone tube is rare. This report describes a unique case of secondary dacryocystitis and the contracture of dacryocyst caused by a lacrimal silicone tube that was placed in the lacrimal system for 10 years.
A 63-year-old female was diagnosed with chronic dacryocystitis at a local hospital and underwent surgical treatment 10 years ago. In the past month, the patient complained of persistent tearing and purulent secretion from the eyes.
The patient was diagnosed with secondary dacryocystitis, based on clinical features and the presence of the silicone stent, granulation tissue formation, and dacryocyst contracture in the lacrimal duct, as observed by nasal endoscopy.
For treatment, the implanted silicone tube in the patient was removed, the lacrimal duct and nasal mucosa was anastomosed, and a new lacrimal silicone tube was placed again.
Following the surgery, the patient recounted that there were no symptoms, and follow-up examinations performed over a 1-month period posttreatment revealed no recurrence of obstruction or dacryocystitis. Therefore, the surgeon removed the lacrimal drainage tube and asked the patient to return to the outpatient department regularly for examination.
The findings, in this case, suggest that silicone tubes are safe and effective, and can be placed in the lacrimal drainage system. However, in this patient, prolonged intubation caused chronic inflammation, granulation tissue formation, and dacryocyst contracture. Our findings could inform surgeons to consider the reasonable duration of intubation for treating cases of lacrimal obstruction, in order to avoid unnecessary complications.
植入泪道硅胶管导致泪囊挛缩的情况较为罕见。本报告描述了一例独特的继发性泪囊炎病例，该病例由一根放置在泪道系统长达10年的泪道硅胶管引起泪囊挛缩。
一名63岁女性在当地医院被诊断为慢性泪囊炎，并于10年前接受了手术治疗。在过去的一个月里，患者抱怨眼睛持续流泪并有脓性分泌物。
根据临床特征以及鼻内镜检查发现泪道内存在硅胶支架、肉芽组织形成和泪囊挛缩，该患者被诊断为继发性泪囊炎。
为进行治疗，取出了患者体内植入的硅胶管，对泪道和鼻黏膜进行了吻合，并再次置入了一根新的泪道硅胶管。
手术后，患者称没有症状，治疗后1个月内的随访检查显示没有阻塞或泪囊炎复发。因此，外科医生取出了泪道引流管，并要求患者定期返回门诊进行检查。
本病例的研究结果表明，硅胶管是安全有效的，可放置在泪道引流系统中。然而，在该患者中，长期置管导致了慢性炎症、肉芽组织形成和泪囊挛缩。我们的研究结果可为外科医生在治疗泪道阻塞病例时考虑合理的置管时间提供参考，以避免不必要的并发症。
