单眼内窥镜下鼻腔泪囊吻合术后双眼眼表指标的变化

Changes of binocular surface indexes after unilateral endoscopic dacryocystorhinostomy

摘要:

目的：探讨单眼内窥镜下鼻腔泪囊吻合术对双眼眼表指标的影响。

方法：纳入于2022-12-01/2023-07-31诊断为单眼原发性获得性鼻泪管阻塞(PANDO)，并成功实施内窥镜下鼻腔泪囊吻合术的患者45例。收集术前，术后0.5、1、3 mo的眼表指标，包括平均非侵入性泪膜破裂时间(NIBUT)、干燥综合征国际合作临床联盟眼部染色评分(SICCA OSS)、眼睑刷Korb评分、非表面麻醉泪液分泌试验(Schirmer test)。对比手术前后术眼与健眼在各个时间点上的各项指标。

结果：术眼和健眼NIBUT、SICCA OSS、Korb评分、Schirmer test无明显的组间差异(均P>0.05)。术眼术后0.5、1、3 mo的Korb评分明显低于术前(P=0.034、0.044、0.027)。术眼术后1 mo的Schirmer test明显低于手术前(P=0.0461)。

结论：内窥镜下鼻腔泪囊吻合术后泪液引流恢复正常，眼表损伤加重，这些变化通常在术后约1 mo达到峰值，然后逐渐恢复。

Abstract:

AIM: To investigate the effect of unilateral endoscopic dacryocystorhinostomy on binocular surface indexes.

METHODS: Totally 45 cases with monocular primary acquired nasolacrimal duct obstruction(PANDO)who successfully underwent endoscopic dacryocystorhinostomy between 1 December 2022 and 31 July 2023 were enrolled in the study. Ocular surface indexes, including the non-invasive tear break-up time(NIBUT), Sjögren's International Collaborative Clinical Alliance ocular staining score(SICCA OSS), Korb score of lid wiper and Schirmer test scores, were collected preoperatively and at 0.5, 1 and 3 mo post-operatively. Subsequently, various indexes were compared at each time point between the operated and healthy eyes pre- and post-operatively.

RESULTS: There was no significant differences between operated and healthy eyes in NIBUT, SICCA OSS, Korb scores and Schirmer test(all P>0.05). Furthermore, the Korb scores of operated eye at 0.5, 1 and 3 mo post-operatively were significantly lower than the preoperative value(P=0.034, 0.044, 0.027). Moreover, the Schirmer test score of the operated eye at 1 mo post-operatively was significantly lower than the preoperative value(P=0.0461).

CONCLUSION:After a successful endoscopic dacryocystorhinostomy, tear drainage is restored, however, ocular surface damage worsens. These changes typically peak at 1 mo post-operatively before gradually improving.