关键词: 泪道阻塞, 硅胶管泪道义管植入术

Abstract:

Objective To evaluate associations of the success rate of Fr2 silicone intubation for lacrimal duct obstruction. Design Retrospective case series. Participants 332 lacrimal duct obstruction cases (394 eyes). Methods 332 lacrimal duct obstruction cases (394 eyes) were analyzed based on obstructed severity and location, with dacryocystitis or not, previous probing, the operational method, the post-operative irrigation, the timing of silicone tube removal and the number of operations. The success rate of Fr2 silicone intubation was assessed based on the complaints of the patient, the silicone tube removal at post-operative 1 month and the presence of complications. Main Outcome Measures The success rate of silicone intubation. Results Total success rate of intubation was 87%, among which the success rate for the mono-segmental blocking group (n=257) was 92.61%, while it was only 75.91% in the multi-segmental occlusion group (n=137) (χ2＝21.741, P＝0.001 ). The effective rate of intubation in the canaliculusocclusional cases (92.07%) was higher than in the nasolacrimal occlusional cases(84.34%) (χ2＝3.502, P＝0.047). There is no significant difference in effective rate for the nasolacrimal occlusional cases with chronic dacryocystitis (87.72%) and for the cases without dacryocystitis (76.92%) (χ2＝1.576, P＝0.175). With the increase number of pre-operative probing, the efficiency of intubation decreased (χ2＝30.252, P<0.001). The efficiency was only 64.92% in cases with pre-operative probing more than 10 (P<0.05). YAG lacrimal duct formation combined silicone intubation was better than simple silicone intubation in obstruction of canaliculus (χ2＝6.505, P＝0.012). The effective rate was 90.10% in the irrigation1~4/mon group but it was 85.50% in the irrigation ＞4/mon group and 74.47% in the irrigation ＜1/mon group (χ2＝8.219, P＝0.016). Early (<6 weeks, 47.62%) or late (＞6 months, 66.67%) tube removal significantly reduced catheter intubation efficiency (91.63% in the 6 weeks to 3 months group and 88.16% in the 3 to 6 months group) (χ2＝38.880, P＝0.000). The effective rate for the first-surgery group was higher than that of reoperation cases (χ2＝15.548, P＝0.006). Conclusion The obstructed severity, obstructed location, chronic dacryocystitis, pre-operational probing, post-surgery irrigation and the extubation time affect the success rate of Fr2 intubation. YAG lacrimal duct formation combined silicone intubation is better than simple silicone intubation in obstruction of lacrimal canaliculus. (Ophthalmol CHN, 2016, 25: 409-413)

Key words: lacrimal duct obstruction, silicone intubation