激光泪小点成形术/泪小点切开术联合泪道置管治疗泪小点狭窄

Clinical analysis of laser lacrimal point plasty therapy combined with lacrimal intubation for lacrimal point stenosis

摘要:

目的:分析我院激光泪小点成形术/泪小点切开术联合泪道插管治疗泪小点狭窄的可行性、适应证及疗效。方法:回顾性分析我院2009-01/2010-06门诊确诊并行手术的泪小点狭窄或膜闭病例37例41眼。其中20例22眼行Nd:YAG激光泪小点成形联合置管术,17例19眼行泪小点切开联合置管术。拔管后随访3～12mo,随访时观察、记录患者的溢泪情况、泪小点形态和功能恢复情况及手术并发症情况。结果:截至末次随访,两种术式的有效率均为100%,激光联合置管术的治愈率为82%;切开联合置管术的治愈率为79%,两种术式的治愈率未见明显差异。先天性泪小点闭锁的治愈率为100%。泪点周围组织红肿伴眼痒者2例;泪小点撕裂者1例;泪道肉芽增生者1例。无引流管自行滑脱病例。结论:激光泪小点成形术/泪小点切开术联合泪道置管治疗泪小点狭窄疗效肯定。激光联合置管术治疗泪小点狭窄或膜闭手术操作简便,可作为常规术式进行推广。先天性泪小点闭锁可视为切开联合置管术的手术适应证。

Abstract:

AIM:To analyse the feasibility,indications and efficacy of lacrimol point incision combined with lacrimal intubation in our clinic for the treatment of lacrmal point stenosis or occlusion. METHODS:A total of 37 patients (41 eyes) were with lacrmal point stenosis or occlusion.20 patients(22 eyes)underwent Nd:YAG laser combined with lacrimal intubation,17 patients(19 eyes) underwent lacrimol point incision combined with lacrimal intubation.All the cases had an extubation according to recovery.All patients then continued to be followed up for 3 months to 12 months.All patients’ situation of epiphora,the form and function recovery of lacrimal point, and surgical complications were observed and recorded. RESULTS:Until the last following up time,all cases had 100% effective rate.Nd:YAG laser combined with lacrimal intubation had a cure rate of 82% ,the other was 79%.There were no obvious difference between the two types.All the congenital atresia of lacrimal point cases had a 100% cure rate.After surgery,2 cases were with swelling tissue around lacrimal point and itching,1 case with split lacrimal point,1 case with lacrimal passages granulation. No other complications were found.No self-detachment of lacrimal drainage tube was found. CONCLUSION:Combination with lacrimal intubation to treat lacrmal point stenosis is unique and effective.Nd:YAG laser combined with lacrimal intubation is simple for lacrmal point stenosis or congenital atresia ,it deserved to be applied.Congenital closure of lacrimal point may be a surgical indications of lacrimal point incision combined with lacrimal intubation.