Sahan Berna, Ciftci Ferda
Ophthalmology Clinic, Bozyaka Training and Research Hospital, Saim Çıkrıkçı Cad. No:59, 35360, Izmir, Turkey.
Ophthalmology Clinic, Batigoz Hospital, Istanbul, Turkey.
Int Ophthalmol. 2023 Feb;43(2):541-547. doi: 10.1007/s10792-022-02453-9. Epub 2022 Aug 17.
To evaluate the efficacy of trephination and monocanalicular/bicanalicular silicone tube use depending on the number of affected canaliculi in patients with canalicular obstruction.
This retrospective study included 46 eyes of 36 patients who underwent trephination and silicone tube intubation performed by a single experienced oculoplastic surgeon due to canalicular obstruction between 2005 and 2020. Monocanalicular silicone tube was applied to patients with one canalicular obstruction, and bicanalicular silicone tube was applied to those with the upper and lower canalicular involvement of the same eye. Canalicular obstructions were divided into groups according to their localization as proximal, middle, and distal. The silicone tubes were kept in place for at least 5 months after the operation, and the follow-up duration of the patients was at least 12 months.
Twenty (55.6%) patients were female and 16 (44.4%) were male. The mean age was 15.82 ± 7.02 years in the treatment success group and 28.87 ± 12.74 years in the treatment failure group (p = 0.001). While 67.6% of the eyes in the treatment success group had monocanalicular obstruction (monocanalicular silicone tube applied), 66.7% of those in the treatment failure group had bicanalicular obstruction (bicanalicular silicone tube applied) (p = 0.049). The most common distal obstruction was seen in the treatment success group, and the least distal obstruction and the most proximal obstruction were observed in the treatment failure group (p < 0.001). The mean duration silicone tube stay was 9.37 ± 1.96 months in the treatment success group and 7.25 ± 1.42 months in the treatment failure group (p = 0.003).
We consider that trephination with the use of a monocanalicular or bicanalicular silicone tube depending on the number of affected canaliculi can be the first choice of treatment in canalicular obstruction due to its high success rate, especially in distal obstruction.
根据泪小管阻塞患者受累泪小管的数量，评估泪小管切开术及单泪小管/双泪小管硅胶管置入术的疗效。
本回顾性研究纳入了2005年至2020年间因泪小管阻塞由同一位经验丰富的眼整形外科医生进行泪小管切开术及硅胶管置入术的36例患者的46只眼。单泪小管阻塞的患者应用单泪小管硅胶管，同一眼上下泪小管均受累的患者应用双泪小管硅胶管。泪小管阻塞根据其部位分为近端、中段和远端组。术后硅胶管至少留置5个月，患者随访时间至少12个月。
20例（55.6%）为女性，16例（44.4%）为男性。治疗成功组的平均年龄为15.82±7.02岁，治疗失败组为28.87±12.74岁（p = 0.001）。治疗成功组67.6%的眼为单泪小管阻塞（应用单泪小管硅胶管），治疗失败组66.7%的眼为双泪小管阻塞（应用双泪小管硅胶管）（p = 0.049）。治疗成功组远端阻塞最为常见，治疗失败组远端阻塞最少且近端阻塞最多（p < 0.001）。治疗成功组硅胶管平均留置时间为9.37±1.96个月，治疗失败组为7.25±1.42个月（p = 0.003）。
我们认为，根据受累泪小管的数量使用单泪小管或双泪小管硅胶管进行泪小管切开术，因其成功率高，尤其是在远端阻塞时，可作为泪小管阻塞的首选治疗方法。
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