Liu Xueru, Zhang Wenyue, Zhang Leilei, Li Lunhao, Han Yuanhui, Ali Mohammad Javed, Xiao Caiwen
Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
Int Ophthalmol. 2025 Feb 11;45(1):72. doi: 10.1007/s10792-025-03444-2.
To evaluate the efficiency and safety profiles of a technique of simultaneous reconstruction of traumatic lacrimal duct obstruction and medial canthus deformity using micro-anchors.
A retrospective interventional study was performed from 2018 to 2022 on 26 consecutive patients who presented with medial canthal deformities and traumatic nasolacrimal duct obstruction. All patients underwent medial canthoplasty using micro-anchors combined with dacryocystorhinostomy to address the traumatic nasolacrimal duct obstruction. Preoperative and postoperative measurements of telecanthus, the superior or the inferior displacement of the medial canthal tendon (MCT), surgical technique of MCT fixation, advantages and limitations of using micro-anchors, functional and cosmetic outcomes were recorded and compared.
Satisfactory and symmetrical medial canthal fixation outcomes were achieved in 96% (25/26) patients using the micro-anchors. The surgical technique was easy and offered secure and reliable reattachment of the MCT in long-term. The DCR surgery was anatomically and functionally patent in 92% (24/26) patients. One patient had unsatisfactory medial canthal outcomes where the canthus remained partly lateral, and inferior compared to the uninjured side. The two failures following DCR surgery were secondary to complete cicatricial closure and had persistent epiphora.
The present study noted that micro-anchors can correct the medial canthal deformity and leave more space for the DCR osteotomy simultaneously.
评估使用微型锚钉同时修复外伤性泪道阻塞和内眦畸形技术的有效性和安全性。
对2018年至2022年连续收治的26例伴有内眦畸形和外伤性鼻泪管阻塞的患者进行回顾性干预研究。所有患者均接受了使用微型锚钉联合泪囊鼻腔吻合术的内眦成形术，以解决外伤性鼻泪管阻塞问题。记录并比较术前和术后的内眦距、内眦韧带（MCT）上移或下移情况、MCT固定的手术技术、使用微型锚钉的优缺点、功能和美容效果。
96%（25/26）的患者使用微型锚钉获得了满意且对称的内眦固定效果。手术技术简便，长期来看能为MCT提供安全可靠的重新附着。92%（24/26）的患者泪囊鼻腔吻合术在解剖和功能上通畅。1例患者内眦效果不满意，内眦部分仍位于外侧，且比未受伤侧低。泪囊鼻腔吻合术后的2例失败病例继发于完全瘢痕性闭合，且持续性溢泪。
本研究指出，微型锚钉可矫正内眦畸形，同时为泪囊鼻腔吻合术截骨术留出更多空间。
