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原发性获得性鼻泪管阻塞患者行外鼻内囊吻合术与经鼻内窥镜激光辅助鼻内囊吻合术的疗效比较。

Comparison of Outcomes of External Dacryocystorhinostomy and Transcanalicular Laser-Assisted Dacryocystorhinostomy in Patients with Primary Acquired Nasolacrimal Duct Obstruction.

机构信息

Department of Ophthalmology, Kayseri City Education and Research Hospital, Kayseri, Turkey.

Department of Ophthalmology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey.

出版信息

Klin Monbl Augenheilkd. 2022 Jun;239(6):799-803. doi: 10.1055/a-1720-1752. Epub 2022 Feb 18.

Abstract

PURPOSE

This study aimed to compare anatomical and functional outcomes of external dacryocystorhinostomy (EX-DCR) and transcanalicular multidiode laser dacryocystorhinostomy (TDL-DCR) in patients with primary acquired nasolacrimal duct obstruction (PANDO).

METHODS

This study was conducted on 60 eyes of 60 patients with PANDO. The study subjects were randomly divided into two groups. Group 1 included 30 patients who underwent EX-DCR, and group 2 included 30 patients who underwent TDL-DCR. Surgery success rates were determined by patency of the neo-ostium, with free saline flow on irrigation and the absence of epiphora.

RESULTS

There were 23 women (76.7%) and 7 men (23.3%) with a mean age of 47.33 ± 12.44 years in group 1, and 18 women (60%) and 12 men (40%) with a mean age of 46.2 ± 19.4 years in group 2. There was no significant difference between groups 1 and 2 with respect to age or gender (p = 0.801, p = 0.267, respectively). The mean duration of symptoms was 3.2 years, ranging from 1.5 to 5 years. The mean postoperative follow-up was 12.3 ± 2.44 months. At the end of the follow-up period, the surgery success rates were 96.7% (29/30 eyes) in group 1, and 90% (27/30 eyes) in group 2. There was no statistical difference in the surgery success rates between groups (p = 0.612).

CONCLUSION

TDL-DCR is a minimally invasive and safe procedure. The lack of bleeding and incision scar and shorter operation time suggest that TDL-DCR can be a good alternative in PANDO patients.

摘要

目的

本研究旨在比较原发性获得性鼻泪管阻塞(PANDO)患者行外鼻泪囊吻合术(EX-DCR)和经泪小管多二极管激光鼻泪囊吻合术(TDL-DCR)的解剖和功能结果。

方法

本研究纳入了 60 例 PANDO 患者的 60 只眼。研究对象随机分为两组,组 1 为 30 例接受 EX-DCR 的患者,组 2 为 30 例接受 TDL-DCR 的患者。手术成功率通过新造口通畅、冲洗时有自由盐水流出且无溢泪来确定。

结果

组 1 中,23 例女性(76.7%)和 7 例男性(23.3%),平均年龄为 47.33±12.44 岁,组 2 中,18 例女性(60%)和 12 例男性(40%),平均年龄为 46.2±19.4 岁。两组在年龄或性别方面无显著差异(p=0.801,p=0.267)。症状平均持续时间为 3.2 年,范围为 1.5 至 5 年。平均术后随访时间为 12.3±2.44 个月。在随访期末,组 1 的手术成功率为 96.7%(29/30 只眼),组 2 的手术成功率为 90%(27/30 只眼)。两组手术成功率无统计学差异(p=0.612)。

结论

TDL-DCR 是一种微创且安全的手术方法。术中出血少、无切口瘢痕且手术时间短,提示 TDL-DCR 可作为 PANDO 患者的一种良好选择。

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