Qin Ying-Yan, Li Zuo-Hong, Lin Feng-Bin, Jia Yu, Mao Jun, Wang Cong-Yao, Liang Xuan-Wei
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China.
Int J Ophthalmol. 2021 Jan 18;14(1):106-111. doi: 10.18240/ijo.2021.01.15. eCollection 2021.
To identify the risk factors of epiphora in patients with anatomical patency after surgical repair of canalicular laceration.
This retrospective case series included 178 cases of canalicular laceration repair from 2005 to 2012. Demographic data collected from each patient included age, sex, type of injury, distance from the distal lacerated end of the canaliculus to the punctum, the severity score for the structural abnormity of the medial canthus, the duration of stent placement, and the timing of surgery. The risk factors for epiphora were evaluated using Logistic regression models.
Among the 178 cases, 45 (25.3%) with lacrimal patency after irrigation had symptomatic epiphora at the final follow-up. Patients' sex, age, type of injury, duration of stent placement, timing of surgery, and concurrent trauma were not found to be significantly associated with symptomatic epiphora after surgical repair of the lacerated canaliculus (>0.05). A distance of more than 5 mm from the distal cut end to the punctum was closely and significantly associated with symptomatic epiphora after surgical repair of the lacerated canaliculus (<0.01). Symptomatic epiphora was significantly more frequent in patients with higher severity scores for structural abnormities of the medial canthus (<0.01).
Our results indicate that the risk factors for postoperative symptomatic epiphora include a further distance between the distal cut end and the lacrimal punctum and a higher severity score for structural abnormities of the medial canthus. These findings could be used to prognosticate postoperative symptomatic epiphora.
确定泪小管断裂手术修复后解剖结构通畅患者溢泪的危险因素。
本回顾性病例系列研究纳入了2005年至2012年期间178例泪小管断裂修复病例。收集的每位患者的人口统计学数据包括年龄、性别、损伤类型、泪小管远端断裂端至泪点的距离、内眦结构异常的严重程度评分、支架置入时间和手术时机。采用Logistic回归模型评估溢泪的危险因素。
178例患者中,45例(25.3%)冲洗后泪道通畅,但在最后随访时出现症状性溢泪。未发现患者的性别、年龄、损伤类型、支架置入时间、手术时机和并发创伤与泪小管断裂手术修复后的症状性溢泪有显著相关性(>0.05)。泪小管远端断端至泪点距离超过5 mm与泪小管断裂手术修复后的症状性溢泪密切相关且具有显著统计学意义(<0.01)。内眦结构异常严重程度评分较高的患者症状性溢泪明显更常见(<0.01)。
我们的结果表明,术后症状性溢泪的危险因素包括远端断端与泪点之间的距离更远以及内眦结构异常的严重程度评分更高。这些发现可用于预测术后症状性溢泪。