Zhan Zhiyun, Zhang Jingjin, Huang Enna, Qu Qiang, Wang Ting, Wang Tingting
Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian, China.
Department of Ophthalmology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian, China.
J Ophthalmol. 2025 Jun 24;2025:4709728. doi: 10.1155/joph/4709728. eCollection 2025.
Surgical excision of tumors near the lacrimal punctum presents challenges due to the risk of damaging the lacrimal duct, leading to chronic epiphora. Effective reconstruction is essential to preserve lacrimal function and maintain esthetic outcomes. This study discusses the short- to mid-term results of nine cases using conjunctival flap transposition and artificial lacrimal duct placement for repair, considering the duct's anatomical and functional aspects. We report on nine patients with benign lesions involving the lacrimal punctum at our hospital from August 2019 to September 2022. A conjunctival flap with a reasonable design based on the defect area was used to cover the defect, and double-tube placement of artificial lacrimal ducts was performed along with suturing of the remaining lacrimal point and lacrimal canaliculus epithelium. Pathological examination of all nine patients after surgery showed "melanocytic nevus." The conjunctival flap survived in the first phase, the lacrimal point remained unblocked, there were no abnormalities in the lower eyelid or medial canthus, the appearance was aesthetically pleasing, lacrimal duct irrigation was unobstructed, and there was no tearing after surgery. All patients were followed up for more than 1 year, and no tumor recurrence or obstruction in the lacrimal duct was observed. Conjunctival flap transposition and artificial lacrimal duct placement is an effective surgical approach for the repair of defects following lacrimal punctum tumor excision. The method not only preserves lacrimal duct function but also achieves satisfactory esthetic results, making it a reliable choice for clinical application.
由于存在损伤泪道导致慢性溢泪的风险，泪小点附近肿瘤的手术切除具有挑战性。有效的重建对于保留泪道功能和维持美观效果至关重要。本研究从泪道的解剖和功能方面出发，探讨了9例采用结膜瓣转位联合人工泪道植入进行修复的近期至中期结果。我们报告了2019年8月至2022年9月在我院就诊的9例累及泪小点的良性病变患者。根据缺损面积设计合理的结膜瓣覆盖缺损，并进行人工泪道双管植入，同时缝合剩余泪点和泪小管上皮。9例患者术后病理检查均显示为“黑素细胞痣”。结膜瓣一期存活，泪点通畅，下睑及内眦无异常，外观美观，泪道冲洗通畅，术后无流泪。所有患者均随访1年以上，未观察到肿瘤复发或泪道阻塞。结膜瓣转位联合人工泪道植入是泪小点肿瘤切除术后缺损修复的一种有效手术方法。该方法不仅保留了泪道功能，还取得了满意的美观效果，是临床应用的可靠选择。
