Ouyang Gao-Xiang, Bai Fang, Tao Hai
Department of Ophthalmology, the Third People's Hospital of Dalian, Dalian 116033, Liaoning Province, China.
Lacrimal Center, Senior Department of Ophthalmology, the Third Medical Center of Chinese PLA General Hospital, Beijing 100039, China.
Int J Ophthalmol. 2023 Apr 18;16(4):539-546. doi: 10.18240/ijo.2023.04.07. eCollection 2023.
To determine the efficacy and safety of pedicled conjunctival lacrimal duct reconstruction in the treatment of severe obstruction of superior and inferior lacrimal canaliculi with conjunctivochalasis.
This study was performed as a retrospective analysis of patients who received conjunctival dacryocystorhinostomy with pedicled conjunctival flap reconstruction combined with tube intubation due to severe superior and inferior lacrimal canalicular obstruction with conjunctivochalasis from January 2019 to October 2019. The clinical data included the degree of preoperative epiphora and postoperative relief, preoperative examination of lacrimal duct computed tomography and ultrasound biomicroscopy, postoperative evaluation of lacrimal duct function by chloramphenicol taste and fluorescein dye disappearance test, . Syringing was carried out to determine the reconstruction and patency of the lacrimal duct.
All 9 patients (9 eyes) had severe canalicular obstruction with conjunctivochalasis. The patients included 4 males and 5 females aged between 47-65y with an average age of 52.2±6.7y. At 3mo follow-up, the tube was removed and the patients were followed for a further 3mo. After tube removal, 6 patients showed no epiphora. These patients also had positive chloramphenicol tastes and normal fluorescein dye disappearance test results. Two patientshad epiphora. Also, syringing showed partial patency of the reconstructed lacrimal duct. One patient had no improvement in epiphora with negative chloramphenicol taste and fluorescein dye disappearance test results and obstruction of the reconstructed lacrimal duct. The total effective rate of the operation was 8/9, with no serious complications.
Pedicled conjunctival lacrimal duct reconstruction conjunctival dacryocystorhinostomy is safe and effective for superior and inferior canalicular obstruction with conjunctivochalasis.
探讨带蒂结膜泪道重建术治疗伴有结膜松弛的上下泪小管严重阻塞的疗效及安全性。
本研究对2019年1月至2019年10月因伴有结膜松弛的上下泪小管严重阻塞而接受带蒂结膜瓣重建联合置管的结膜泪囊鼻腔吻合术的患者进行回顾性分析。临床资料包括术前溢泪程度及术后缓解情况、术前泪道计算机断层扫描及超声生物显微镜检查、术后通过氯霉素味觉试验和荧光素染料消失试验评估泪道功能。进行冲洗以确定泪道重建情况及通畅性。
9例患者（9只眼）均有严重的泪小管阻塞并伴有结膜松弛。患者包括4例男性和5例女性，年龄在47 - 65岁之间，平均年龄为52.2±6.7岁。在3个月随访时拔管，并对患者进一步随访3个月。拔管后，6例患者无溢泪。这些患者氯霉素味觉试验结果为阳性，荧光素染料消失试验结果正常。2例患者仍有溢泪。冲洗显示重建的泪道部分通畅。1例患者溢泪无改善，氯霉素味觉试验结果为阴性，荧光素染料消失试验结果异常，重建的泪道阻塞。手术总有效率为8/9，无严重并发症。
带蒂结膜泪道重建结膜泪囊鼻腔吻合术治疗伴有结膜松弛的上下泪小管阻塞安全有效。
