Jafarizadeh Ali, Manouchehri Vahideh, Sobhi Navid, Mousavi Farideh, Tondro Anamag Farhad
Nikookari Eye Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Ophthalmology and Visual Neurosciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Heliyon. 2024 Aug 13;10(16):e36245. doi: 10.1016/j.heliyon.2024.e36245. eCollection 2024 Aug 30.
To evaluate how risk factors impact success rates of initial probing and nasolacrimal duct (NLD) tube intubation in children over 18 months of age with congenital nasolacrimal duct obstruction (CNLDO).
This cohort study included 98 CNLDO patients aged 18 months to 10 years who underwent NLD probing with stent insertion. We employed the multivariate frailty model as our final model to conceptually elaborate on our correlated eye data, with the primary outcome measure evaluating the success rates of probing and tube intubation. Factors such as age, probing complexity, tube type, prior surgeries, and passive smoking were considered in the evaluation.
The study involved 98 patients (54 males, 44 females) with a mean age of 41.46 months and an average follow-up of 98.37 days (95 % CI 87.65-109.1). Out of the 110 eyes that underwent surgery, 13 (11.8 %) experienced failure while 97 (88.2 %) were censored. Kaplan-Meier analysis indicated significant differences in age category and probing (P-value = 0.03 and 0.006 respectively), but not tube type (P-value = 0.8). Multivariable analysis confirmed that older age and complex probing were associated with higher failure rates in CNLDO cases, with each monthly increase correlating to a two percent higher likelihood of intubation failure.
Patient age and probing complexity influence CNLDO treatment, impacting surgical techniques and outcomes. Tube type, prior surgery, and passive smoking have no significant impact on treatment success.
评估风险因素如何影响18个月以上先天性鼻泪管阻塞（CNLDO）患儿初次探通和鼻泪管（NLD）置管的成功率。
本队列研究纳入了98例年龄在18个月至10岁之间的CNLDO患者，这些患者接受了带支架插入的鼻泪管探通术。我们采用多变量脆弱模型作为最终模型，从概念上阐述我们的相关眼部数据，主要结局指标是评估探通和置管的成功率。评估中考虑了年龄、探通复杂性、导管类型、既往手术和被动吸烟等因素。
该研究纳入了98例患者（54例男性，44例女性），平均年龄为41.46个月，平均随访98.37天（95%CI 87.65 - 109.1）。在接受手术的110只眼中，13只（11.8%）失败，97只（88.2%）被截尾。Kaplan-Meier分析表明年龄类别和探通存在显著差异（P值分别为0.03和0.006），但导管类型无差异（P值 = 0.8）。多变量分析证实，年龄较大和探通复杂与CNLDO病例的较高失败率相关，年龄每增加一个月，置管失败的可能性增加2%。
患者年龄和探通复杂性影响CNLDO治疗，对手术技术和结局产生影响。导管类型、既往手术和被动吸烟对治疗成功无显著影响。
