Beigi B, Westlake W, Chang B, Marsh C, Jacob J, Chatfield J
Department of Ophthalmology, West of England Eye Unit, Royal Devon and Exeter Hospital, UK.
Eye (Lond). 1998;12 ( Pt 3a):358-62. doi: 10.1038/eye.1998.86.
To assess the pre-operative management, surgical technique employed, success rate and patient satisfaction following surgery in patients undergoing dacryocystorhinostomy (DCR) in South West England.
Two hundred and forty-two patients who underwent DCR were retrospectively studied. A telephone questionnaire was used to assess patient satisfaction in 100 patients.
One hundred and thirteen (46%) patients had nasolacrimal duct obstruction, half of whom had a history of dacryocystitis, 70 (29%) had canalicular obstruction and 8 (3%) had mixed blockage. The site of blockage was not known or recorded in 51 patients (22%). Seventy-five (31%) patients underwent DCR, 151 (62%) DCR with insertion of silicon tubes, 9 (4%) DCR and Lester Jones tube, and 7 (3%) canaliculodacryocystorhinostomy (CDCR). Overall an 83.5% success rate was reported by the surgeons. The success rate for patients with a history of dacryocystitis was 98%, for nasolacrimal duct obstruction 96% and for canalicular obstruction 82%. When the site of blockage was not known or recorded the success rate was 60%. Where the name of the surgeon was not recorded there was a 15% successful outcome. Eighty per cent of patients reported some improvement in their symptoms following surgery.
DCR is an effective surgical procedure with a high rate of patient satisfaction. Pre-operative identification of the site of the blockage is likely to improve surgical outcome.
评估英格兰西南部接受泪囊鼻腔吻合术(DCR)患者的术前管理、所采用的手术技术、手术成功率及术后患者满意度。
对242例行DCR手术的患者进行回顾性研究。采用电话问卷调查100例患者的满意度。
113例(46%)患者存在鼻泪管阻塞,其中一半有泪囊炎病史,70例(29%)存在泪小管阻塞,8例(3%)为混合性阻塞。51例(22%)患者阻塞部位不详或未记录。75例(31%)患者接受了DCR手术,151例(62%)接受了DCR并植入硅胶管,9例(4%)接受了DCR及Lester Jones管植入,7例(3%)接受了泪小管泪囊鼻腔吻合术(CDCR)。外科医生报告总体成功率为83.5%。有泪囊炎病史患者的成功率为98%,鼻泪管阻塞患者为96%,泪小管阻塞患者为82%。当阻塞部位不详或未记录时,成功率为60%。未记录外科医生姓名时,成功结果为15%。80%的患者报告术后症状有一定改善。
DCR是一种有效的手术方法,患者满意度高。术前明确阻塞部位可能会改善手术效果。