激光联合不同硅胶管植入治疗不同部位泪道阻塞的疗效

目的：：观察激光联合新型一次性使用泪道再通管( RS型)或泪道扩张引流管(鼻泪管)治疗不同部位泪道阻塞疾病的疗效。方法：针对2011-01/2013-12我院548例657眼泪道阻塞患者，其中泪小管(含泪总管)阻塞患者236例298眼，采用KTP激光联合泪道再通管( RS型)植入术；鼻泪管阻塞患者312例359眼，采用KTP激光联合泪道扩张引流管(鼻泪管)植入术，术后坚持泪道冲洗，手术3 mo后拔除支架，以拔管后3 mo冲洗泪道情况及患者自觉溢泪情况作为评定标准。结果：泪小管(或泪总管)阻塞的患者行KTP激光联合新型RS型泪道再通管植入术，其中治愈248眼，好转33眼，无效17眼；鼻泪管阻塞的患者行KTP激光联合泪道扩张引流管植入术，其中治愈301眼，好转19眼，无效39眼。有效601眼，总有效率91.5％。结论：泪道阻塞患者治疗过程中需制定个性化治疗方案，针对泪道不同部位阻塞激光联合不同硅胶管植入经临床观察疗效肯定，可作为基层医院泪道阻塞患者首选治疗方式。

Clinical analysis of laser therapy combined with different silicone tube implantation for lacrimal duct obstruction in different parts

AIM:To observe the effect of laser therapy combined with disposable lacrimal recanalization catheter(RS model)or dilating lacrimal drainage tube(nasolacrimal canal)for lacrimal duct obstruction in different parts.

METHODS:Form January 2011 to December 2013 in our hospital, 548 patients(657 eyes)with lacrimal duct obstruction were selected. In these patients, 236 patients(298 eyes)with canalicular(or lacrimal duct)obstruction undergone KTP laser combined with RS model disposable lacrimal recanalization catheter; 312 patients(359 eyes)with nasolacrimal duct obstruction undergone KTP laser therapy combined with dilating lacrimal drainage tube. The irrigation of lacrimal passage was sustained. The ducts were removed at 3mo after operations. The condition of lacrimal passage irrigating and the self-reported epiphora at 3mo after tubes removed were taken as evaluating standard.

RESULTS:There were 248 eyes with canalicular(or lacrimal duct)obstruction treated by KTP laser combined with RS duct cured, 33 eyes becoming better, 17 eyes ineffective; there were 301 eyes with nasolacrimal duct obstruction treated by KTP laser combined with dilating lacrimal drainage tube cured, 19 eyes becoming better, 39 eyes ineffective. The total efficiency rate was 91.5%.

CONCLUSION:Patients with lacrimal passage obstruction should be treated with individualized therapy. Laser therapy combined with different silicone tube implantation for lacrimal duct obstruction in different parts is effective and can be used as the preferred method for patient with lacrimal passage obstruction in primary hospital.