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[摘要]
目的:评估以不同的方法治疗病毒性结膜炎并发症泪小点及泪小管闭塞的疗效。
方法:此回顾性群组研究共纳入35例临床确诊为感染病毒性结膜炎的患者,经治疗后完全缓解,4wk后并发泪小点闭塞。本研究采用了泪小点扩张术,穿孔硅胶泪小点栓子植入术, 和Mini-Monoka硅胶管植入术对该35例泪小点闭塞患者进行治疗。
结果:首先,单独采用泪小点扩张术对所有35例患者进行治疗,其中只有6例患者(17.14%)取得了满意的疗效。其次,采用穿孔泪小点栓子植入术对上述采用泪小点扩张术无效的患者进行治疗, 有20例(57.14%)患者取得了较好的疗效。最后,采用Mini-Monoka管植入术对上述两种治疗方案都无效的患者进行治疗,有9例(25.71%)患者的病情取得了重大的改善。另外,通过对上述病例进行统计分析,结果表明该疾病的严重程度与Mini-Monoka管的使用和是否双眼同时患病或者和上、下泪小点同时闭塞并无关联。
结论:运用穿孔硅胶泪小点栓子能够有效治疗由病毒性结膜炎引起的泪小点闭塞。对分别经泪小点扩张术和穿孔硅胶泪小点栓子植入术治疗无效的患者,可采用Mini-Monoka管植入术以取得良好的治疗效果。
[Key word]
[Abstract]
AIM: To evaluate the effect of different methods in managing punctual and canalicular stenosis as a complication of viral conjunctivitis.
METHODS: A retrospective cohort study, including 35 cases of punctal stenosis post-viral conjunctivitis. Cases were diagnosed clinically and treated after 4wk of complete remission from epidemic keratoconjunctivitis. Patients were treated with mechanical dilatation, insertion of perforated silicon punctual plugs or the use of Mini-Monoka stent.
RESULTS: Six out of 35(17.14%)had a satisfactory outcome by punctal dilatation alone. Punctal dilatation with insertion of perforated punctal plugs was done in 20 cases(57.14%). Nine cases(25.71%)had punctal dilatation with Mini-Monoka tube insertion. Disease severity and the use of Mini-Monoka silicon tube did not correlate with bilateral eye involvement or involvement of both upper and lower punctum.
CONCLUSION: Management of punctal occlusion post viral conjunctivitis may be treated easily using perforated punctal plugs. Silicon intubation with Mini-Monoka might be needed to manage resistant cases.
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