Lekskul Apatsa, Preechaharn Puncharut, Jongkhajornpong Passara, Wuthisiri Wadakarn
Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Clin Ophthalmol. 2022 Jun 7;16:1821-1828. doi: 10.2147/OPTH.S362680. eCollection 2022.
To evaluate the resolution rate of lacrimal sac massage and the efficacy of primary probing among different age groups of patients with CNLDO in Thai population.
Retrospectively reviewed the medical records of patients younger than 10 years of age who had been diagnosed with CNLDO, from January 1st, 2011, to October 31st, 2021. Patients were divided into two groups. The conservative treatment group comprised patients who had received Crigler's maneuver and topical antibiotic when indicated; the intervention group comprised patients who had received probing.
There were 469 patients in the conservative treatment group and 108 patients in the probing group. In the conservative treatment group; the patients were categorized into five groups according to age: 0 to <6 months, 6 to <12 months, 12 to <18 months, 18 to <24 months, and ≥24 months. The resolution rates for these age groups were 99.25%, 96.23%, 64.71%, 50%, and 62.07%, respectively. The rate of spontaneous resolution was significantly associated with patient age (p <0.01). In the intervention group; the patients were categorized into four age groups according to age: 0 to <12 months, 12 to <24 months, 24 to <36 months, and ≥36 months. The success rates of primary probing for these age groups were 92.86%, 89.29%, 85.71%, and 94.12%, respectively. The success rate of primary probing was not significantly associated with patient age (p >0.05).
The Crigler's maneuver is a safe and highly effective procedure for the management of CNLDO in patients of multiple ages, particularly patients less than 12 months of age. According to the high spontaneous resolution rate and the low rate of complications, the clinicians may delay surgical intervention when desired.
评估泰国人群中不同年龄组先天性鼻泪管阻塞（CNLDO）患者泪囊按摩的治愈率及初次探通术的疗效。
回顾性分析2011年1月1日至2021年10月31日期间诊断为CNLDO的10岁以下患者的病历。患者分为两组。保守治疗组包括接受克里格勒手法及必要时局部使用抗生素的患者；干预组包括接受探通术的患者。
保守治疗组有469例患者，探通组有108例患者。在保守治疗组中，患者按年龄分为五组：0至<6个月、6至<12个月、12至<18个月、18至<24个月和≥24个月。这些年龄组的治愈率分别为99.25%、96.23%、64.71%、50%和62.07%。自愈率与患者年龄显著相关（p<0.01）。在干预组中，患者按年龄分为四组：0至<12个月、12至<24个月、24至<36个月和≥36个月。这些年龄组初次探通术的成功率分别为92.86%、89.29%、85.71%和94.12%。初次探通术的成功率与患者年龄无显著相关性（p>0.05）。
克里格勒手法是治疗多个年龄段CNLDO患者的一种安全且高效的方法，尤其是12个月以下的患者。鉴于高自愈率和低并发症发生率，临床医生可在需要时推迟手术干预。
