Farrokhi Sanaz, Schüttauf Frank, Spitzer Martin S, Mehlan Juliane
Klinik und Poliklinik fürAugenheilkunde, Universitätsklinikum Hamburg Eppendorf, Martinistr. 52, 20251, Hamburg, Deutschland.
Ophthalmologe. 2021 Oct;118(10):1031-1037. doi: 10.1007/s00347-020-01263-7. Epub 2020 Nov 17.
The optimal timing for surgery of congenital nasolacrimal duct obstruction (CNLDO) is controversially discussed . An aspect that has not yet been studied in this context is the path from first symptoms to the initial diagnosis and surgical treatment with respect to social factors and burden of suffering. The aim of this study was a real-life analysis of the entire course of the disease.
Monocentric, retrospective study evaluating children with CNLDO (n = 147) who underwent surgery. The minimum follow-up was 3 months (26 ± 14 months). The patient information was collected by telephone using a questionnaire especially created for this purpose. The famelial suffering was measured on a scale of 1-5.
Data were collected from 118 parents with a mean follow-up of 26 months. First symptoms occurred at a median age of 1 month. The diagnosis was confirmed through a pediatrician/ophthalmologist after a median of 6 months. An assignment to a referral center for surgical treatment was performed a median of 18 months after the first presentation. The average age of the patients at the time of surgery was 23 months. Surgery before the age of 13 months showed a 100% success rate. The average age of those who needed revision surgery was 27 months (±12 months). The familial suffering was measured as 4.1 points before surgery and 1.3 after surgery.
This study is the first real-life study, which illustrates the path of CNLDO from the first symptoms to rehabilitation, including influential social factors. Early surgery significantly shortens the suffering of both patients and parents. Considering the low operative risks and excellent success rate of operative treatment, an early consultation at a surgical department is recommended.
先天性鼻泪管阻塞（CNLDO）手术的最佳时机存在争议。在此背景下尚未研究的一个方面是从首次出现症状到初始诊断以及手术治疗过程中社会因素和痛苦负担方面的情况。本研究的目的是对该疾病的整个病程进行实际分析。
一项单中心回顾性研究，评估接受手术的CNLDO患儿（n = 147）。最短随访时间为3个月（26±14个月）。通过电话使用专门为此创建的问卷收集患者信息。家庭痛苦程度采用1 - 5分制进行衡量。
收集了118位家长的数据，平均随访时间为26个月。首次症状出现的中位年龄为1个月。中位6个月后由儿科医生/眼科医生确诊。首次就诊后中位18个月被转诊至手术治疗中心。患者手术时的平均年龄为23个月。13个月前手术成功率为100%。需要再次手术的患者平均年龄为27个月（±12个月）。手术前家庭痛苦程度评分为4.1分，手术后为1.3分。
本研究是第一项实际研究，阐述了CNLDO从首次症状到康复的过程，包括有影响的社会因素。早期手术显著缩短了患者和家长的痛苦。考虑到手术风险低且手术治疗成功率高，建议尽早到外科就诊。
