Characterization of the geometric properties of the sclero-conjunctival structure: a review

AIM: To investigate the variation of IGSF3 gene in three families with congenital absence of lacrimal puncta and canaliculi, and to lay a foundation for further research on the pathogenic gene of congenital lacrimal duct agenesis. METHOD: The members of the three families were recruited. The ophthalmologic examinations in details, including slit-lamp biomicroscope, intraocular pressure and fundus examination, etc were carried out. All patients were checked with paracentesis of puncta membrane and lacrimal duct probing, as well as the CT-DCG (computed tomography-dacryocystography). Peripheral blood of 13 participants (3 normal) from three families were collected, 4 mL each, for genomic DNA extraction, and 11 exon fragments of IGSF3 gene were amplified and sequenced by polymerase chain reaction (PCR) to determine whether there were IGSF3 genetic variation. RESULTS: A total of 13 members from three families were screened for 4 synonymous variants: c.930C>T (p.Pro366=), c.1359T>C (p.Ser709=), c.1797G>A (p.Ser855=), c.1539G>A (p.Ser769=), and 6 missense variants: c.1507G>A (p.Gly759Ser), c.1783T>C (p.Trp851Arg), c.1952G>T (p.Ser 907Ile), c.3120C>G (p.Asp1040Glu), c.3123C>G (p.Asp1041Glu), c.3139_3140insGAC (p.Asp1046_Pro1047insAsp), and the latter three were only found in two patients with absence of lacrimal puncta and canaliculi combined with congenital osseous nasolacrimal canal obstruction from the first family. CONCLUSION: The same IGSF3 gene mutation c.3139_3140insGAC is found in the patients with congenital absence of lacrimal puncta and canaliculi combine with osseous nasolacrimal canal obstruction.     

Novel mutations in CRYBB1/CRYBB2 identified by targeted exome sequencing in Chinese families with congenital cataract

AIM: To summarize the phenotypes and identify the underlying genetic cause of the CRYBB1 and CRYBB2 gene responsible for congenital cataract in two Chinese families. METHODS: Detailed family histories and clinical data were collected from patients during an ophthalmologic examination. Of 523 inheritable genetic vision system-related genes were captured and sequenced by targeted next-generation sequencing, and the results were confirmed by Sanger sequencing. The possible functional impacts of an amino acid substitution were performed with PolyPhen-2 and SIFT predictions. RESULTS: The patients in the two families were affected with congenital cataract. Sixty-five (FAMILY-1) and sixty-two (FAMILY-2) single-nucleotide polymorphisms and indels were selected by recommended filtering criteria. Segregation was then analyzed by applying Sanger sequencing with the family members. A heterozygous CRYBB1 mutation in exon 4 (c.347T>C, p.L116P) was identified in sixteen patients in FAMILY-1. A heterozygous CRYBB2 mutation in exon 5 (c.355G>A, p.G119R) was identified in three patients in FAMILY-2. Each mutation co-segregated with the affected individuals and did not exist in unaffected family members and 200 unrelated normal controls. The mutation was predicted to be highly conservative and to be deleterious by both PolyPhen-2 and SIFT. CONCLUSION: The CRYBB1 mutation (c.347T>C) and CRYBB2 mutation (c.355G>A) are novel in patients with congenital cataract. We summarize the variable phenotypes among the patients, which expanded the phenotypic spectrum of congenital cataract in a different ethnic background.     

非典型Stickler综合征I型三个家系的遗传分析及产前诊断

目的：:分析非典型Stickler综合征I型患者的临床表现和遗传学病因,为患者基因诊断、遗传咨询、产前诊断提供理论依据。方法：:实验研究。收集3个典型Stickler综合征I型家系患者的临床表型资料,采集患者及家系其他成员的外周血提取基因组DNA。应用全外显子组测序筛查可疑基因变异,对候选变异进行Sanger测序验证并...     

Novel mutations in the carbohydrate sulfotransferase gene (CHST6) in American patients with macular corneal dystrophy

PURPOSE: To further characterize the mutations within the CHST6 gene responsible for causing macular corneal dystrophy in a cohort of affected patients from the United States. DESIGN: Experimental study. METHODS: Genomic DNA was extracted from buccal epithelium of 16 affected patients (14 families), 17 unaffected relatives, and 127 controls, followed by polymerase chain reaction amplification and direct sequencing of the CHST6 coding region. Subtyping of affected patients into type I and II macular corneal dystrophy was performed by measuring antigenic keratan sulfate (AgKS) serum levels. Haplotype analysis was performed in families that demonstrated common mutations. RESULTS: CHST6 coding region analysis in 10 patients identified as having type I macular corneal dystrophy revealed 10 sequence changes: eight missense mutations, four of which are novel (Met104Val, Tyr110Cys, Gln122Pro, and Leu276Pro) and four of which have been reported previously (Ser51Leu, Pro72Ser, Cys102Gly, and Leu200Arg); one novel homozygous nonsense mutation in two patients from a single family (c. 1683C>T, Gln331X); and one frameshift mutation in a heterozygous state in a single patient (c.1744_1751dupGTGCGCTG). Mutation analysis in the four patients identified as having type II macular corneal dystrophy (serum samples were not obtained from two affected patients) revealed three patients heterozygous for either the c.923G>C, c.969C>A, or c.1519T>C sequence changes. The fourth patient was compound heterozygous for c.969C>A and c.1291T>G. None of these changes was observed in 127 control individuals. Haplotype analysis using microsatellite markers flanking the CHST6 gene did not reveal a common founder for the Leu200Arg (1291T>G) missense mutation, present in five families, identifying this position as a mutation hot-spot. CONCLUSIONS: A variety of previously unreported mutations in the coding region of the CHST6 gene are associated with type I macular corneal dystrophy in a cohort of patients from the United States.     

Diagnosis of lacrimal canalicular diseases using ultrasound biomicroscopy:a preliminary study

AIM: To evaluate the application of ultrasound biomicroscopy (UBM) in the examination of lacrimal canalicular diseases, and to investigate UBM image characteristics of lacrimal canaliculi in disease states.METHODS:Sixty cases (63 eyes, 69 canaliculi) of lacrimal canalicular diseases were enrolled that included 32 patients (32 eyes, 32 canaliculi) with chronic lacrimal canaliculitis, 18 patients (18 eyes, 18 canaliculi) with previous lacrimal canalicular laceration, 9 patients (12 eyes, 18 canaliculi) with congenital absence of lacrimal puncta and canaliculi, and 1 case (1 eye, 1 canaliculus) of canalicular mass. The patients were examined using UBM, and disease-specific features of the UBM images were noted.RESULTS:UBM imaging of lacrimal canaliculi in chronic canaliculitis patients showed obvious ectasia of the lacrimal canalicular lumen. Dot-like moderate echoic signals were detected on some ectatic lumina of the lacrimal canaliculus. Some lumen-like structures of the lower lacrimal canaliculus were observed in 2 (2 eyes, 2 canaliculi) of the 9 patients (12 eyes, 18 canaliculi) with congenital absence of the lacrimal canaliculus. Of the 18 patients (18 eyes, 18 canaliculi) with previous lacrimal canalicular laceration, the lacerated end on the nasal side of the lacrimal canaliculus was detected only in 14 patients (14 eyes, 14 canaliculi).CONCLUSION:UBM can be used to evaluate lacrimal canalicular diseases and can provide an imaging basis for the diagnosis of lacrimal canalicular diseases.     

Investigation of the association between normal-tension glaucoma and single nucleotide polymorphisms in natriuretic peptide gene

PURPOSE: The expression of natriuretic peptides in the neural bundles of the anterior portion of the optic nerves and their functions in regulating vessel tone and blood flow may suggest a possible role in the pathogenesis of glaucoma. The purpose of this study was to investigate the association between normal-tension glaucoma and the genetic variations of atrial natriuretic peptide (Nppa) and natriuretic peptide receptor A (Npr1) gene. METHODS: Sixty-seven Korean normal-tension glaucoma (NTG) patients and 100 healthy subjects (as normal controls) were enrolled. DNA from peripheral blood leukocytes was extracted, and the genotypes of five polymorphisms (c.94G>A, c.454T>C, IVS1+16C>T, IVS2+701G>A, and c.-764C>G) in the Nppa gene and one polymorphism (c.1023G>C) in the Npr1 gene were determined using the restriction fragment length polymorphism and the SNaPshot methods. The genotype and allele frequencies of these polymorphisms in patients with NTG and normal controls were compared using the Fisher's exact test and the chi-square test. RESULTS: In both groups, the genotype distributions were in accordance with the Hardy-Weinberg equilibrium. There was no significant difference in the frequency of the Nppa and Npr1 alleles or genotypes in the normal-tension glaucoma group as compared to the control group. CONCLUSIONS: Nppa and Npr1 gene polymorphisms are not associated with normal-tension glaucoma, suggesting that this gene does not have an important role in the pathogenesis of optic neuropathy in this disease.     

鼻泪管引流管及硅胶管联合置管治疗泪道系统多点阻塞

目的:探讨泪点或泪小管狭窄合并鼻泪管阻塞或合并慢性泪囊炎的泪道引流管治疗方法。方法:临床诊断为泪点或泪小管狭窄合并鼻泪管阻塞或合并慢性泪囊炎的患者23例28眼,经泪道探通后,采用泪道引流管[1]和硅胶管联合置入治疗。结果:术后4mo拔管,随诊1a,患者23例28眼中,23眼无溢泪,泪道冲洗通畅,为治愈,治愈率82%。2眼少许溢泪,泪道冲洗时另一泪点少许返流,探针可达骨壁,可以入咽,为好转,好转率为7%。2眼泪道冲洗原路返流,针头不能达骨壁为无效;1眼泪道冲洗时探针可达鼻骨,但再次出现脓性分泌物,为无效,无效率为11%。结论:鼻泪管引流管和硅胶管联合置入是治疗泪道系统多点阻塞有效的治疗方法。     

No VSX1 gene mutations associated with keratoconus

PURPOSE: To determine whether mutations of the VSX1 gene play a pathogenetic role in the development of keratoconus (KTCN). METHODS: DNA extraction, PCR amplification, and direct sequencing of the VSX1 gene were performed in 100 unrelated patients with diagnoses of clinical and topographic features of KTCN. RESULTS: Of the four previously identified presumed pathogenic mutations in the VSX1 gene (Leu17Pro, Asp144Glu, Leu159Met, and Arg166Trp), only Asp144Glu was identified in a single affected patient. Two novel single nucleotide polymorphisms (SNPs), both resulting in synonymous substitutions, were identified: c.53G>T (Ser6Ser) in four affected patients and c.209G>T (Pro58Pro) in two affected patients. Two previously reported SNPs were also identified: c.426C>A (Arg131Ser) in one affected patient and c.581A>G (Ala182Ala) in 51 of the 100 affected patients. CONCLUSIONS: Only one of the presumed pathogenic mutations in the VSX1 gene, Asp144Glu, was identified in a single member of the cohort of affected patients. However, as previously demonstrated, Asp144Glu is a non-disease-causing polymorphism. The absence of pathogenic mutations in the VSX1 gene in a large number of unrelated KTCN patients indicates that other genetic factors are involved in the development of this disorder.     

Epiphora as a side effect of topical mitomycin C

AIM: To report symptoms and findings of lacrimal duct malfunction after topical mitomycin C (MMC) for conjunctival neoplasia. METHODS: 14 consecutive patients treated with 1-6 cycles of topical 0.04% MMC four times daily for periods of 2 weeks were interviewed about symptoms of lacrimal duct malfunction. Patients who complained of tearing had examination of the puncta and canaliculi including probing and lacrimal duct irrigation. RESULTS: Nine patients complained of epiphora after topical MMC. Three of these patients had normal puncta and canaliculi, patent to irrigation. In these patients epiphora ceased spontaneously after probing and irrigation. The additional six patients had stenosis of the punctum (n = 3), the common canaliculus (n = 1), both puncta and both canaliculi (n = 1) and complete occlusion of the lower canaliculus (n = 1). CONCLUSION: Obstruction of the puncta or canaliculi is not an infrequent event after topical 0.04% MMC.     

激光泪道成形术治疗阻塞性泪道疾病的疗效观察

目的　观察掺钕钇铝石榴石激光泪道成形术治疗阻塞性泪道疾病的疗效 ,并对泪道不同阻塞部位的疗效进行分析。方法　采用掺钕钇铝石榴石激光泪道成形术治疗 6 0 3例 (6 93只眼 )阻塞性泪道疾病患者 ,按泪道阻塞的部位分为泪小点阻塞 (2 3只眼 )、泪小 (总 )管阻塞 (192只眼 )、鼻泪管阻塞 (2 2 7只眼 )、慢性泪囊炎 (2 31只眼 )及外伤性泪小管离断 (2 0只眼 ) 5组 ,术后定期冲洗泪道 ,平均随访 1 5年 ,将各组疗效进行对比分析。结果　泪小点阻塞、泪小 (总 )管阻塞、鼻泪管阻塞、慢性泪囊炎及外伤性泪小管离断组的治愈率和有效率分别为 86 9%和 95 7%、89 1%和 93 8%、93 0 %和96 0 %、78 4 %和 82 7%及 4 0 0 %和 6 5 0 %。经Ridit分析 ,各组 R±S R 分别为 0 92 1± 0 0 2 3、0 914±0 0 0 9、0 92 7± 0 0 0 7、0 85 6± 0 0 13及 0 74 9± 0 0 5 5。慢性泪囊炎组疗效低于鼻泪管和泪小 (总 )管阻塞组 (P <0 0 5 ) ;外伤性泪小管离断组疗效低于其他 4组 (P <0 0 5 )。结论　掺钕钇铝石榴石激光泪道成形术治疗鼻泪管阻塞效果最好 ,其他依次为泪点、泪小 (总 )管阻塞、慢性泪囊炎及外伤性泪小管离断 ,但应严格掌握适应证。     

泪道探通加冲洗治疗婴幼儿泪囊炎的临床研究

目的:研究泪道探通加冲洗治疗婴幼儿泪囊炎的临床疗效。方法:采用7号腰穿针自制的泪道探通冲洗器,黏膜麻醉后,止动。充分扩张泪小点后,将泪道探通冲洗器按常规探通术,由泪小点,泪小管,泪总管,泪囊,穿破隔膜及泪鼻管后,拔出针芯,接冲2g/L盐酸左氧氟沙星冲洗液,边退边冲,患儿出现吞咽动作或呛咳出冲洗液为度。结果:采用此方法治疗婴幼儿泪囊炎33例33眼均为一次性通畅。再次行泪道冲洗者5例5眼(15%),均为一次性治愈。结论:采用泪道探通加冲洗治疗婴幼儿泪囊炎,方法简便、省时,损伤小,疗效快捷,方便,患儿家属易接受。是目前治疗该病症的好方法。     

Conjunctival cicatrizing disease presenting with lacrimal obstruction

Patients with conjunctival cicatrizing disease may develop lacrimal obstruction. Little is published on lacrimal obstruction as the presenting feature of otherwise asymptomatic cicatrizing conjunctival disease. The records of all patients presenting between 1994 and 2015 with lacrimal obstruction found to have cicatrizing conjunctival disease were reviewed. Demographic details, clinical findings, disease progression and treatment were analyzed. Thirty-five patients (25 female), aged 43–91 years (median 74, mean 71.3 years) had epiphora and a mild conjunctival cicatrizing process. Nine patients had onset of epiphora after cataract surgery. All except one patient had obstruction of the proximal lacrimal system (punctum and/or canaliculus). In 14 cases, the obstruction was unilateral (both puncta or canaliculi), with one progressing to bilateral obstruction after 11 years. In 19, all 4 puncta or canaliculi were obstructed. Two patients had unilateral nasolacrimal duct obstruction; one developed contralateral canalicular obstruction 2 years later. Conjunctival biopsies were obtained in 19 of 35 cases (54%), and OCP immunohistochemistry was positive in 7/19 (37%). All other biopsies showed chronic inflammation. Two patients had lichen planus. In follow-up (range 0.1–11 years, mean 3.2 years), 2 patients’ conjunctival disease progressed mildly, and 3 progressed moderately, with 2 of these 5 having positive OCP immunohistochemistry, and 1 having lichen planus. Patients with conjunctival cicatrization may present with lacrimal obstruction, usually punctal or canalicular. Conjunctival disease is usually mild and non-progressive, but patients should be monitored for disease progression.     

先天性白内障一患病家系的致病基因筛查

目的:对先天性核型白内障一患病家系进行致病基因突变筛查,以探索其潜在遗传学缺陷.方法:经过详细的病史采集及临床检查后,应用PCR直接测序法对先证者及其家系内其他9例患者和11名有血缘关系的正常家系成员以及20名无血缘关系的正常对照者进行核型白内障候选基因的突变检测.结果:在该家系患者的GJA8基因发现了c.139G>A的杂合错义突变,导致第47位高度保守的天冬氨酸改变为天冬酰胺(p.D47N),而家系内正常成员及正常对照者中均未发现该突变.结论:p.D47N突变在中国先天性白内障家系中是首次报道.这一突变是该患病家系的潜在遗传学病因,GJA8基因是先天性白内障的致病基因之一.本研究也证实了先天性白内障是一种临床和遗传异质性疾病,特别是在不同种族之间这种异质性更加明显.     

泪小管断裂吻合术两种置管方法的比较

目的 探讨泪小管吻合手术技巧,比较两种泪道置管的疗效.方法 回顾分析95例(95眼)下泪小管断裂吻合术,其中直接夹取法取出鼻泪道引线37例,注水擤鼻法取出鼻泪道引线30例,均逆行置入硅胶管;直接置入硬膜外麻醉管28例,采用X2检验比较两种置管方法的疗效.结果 95例泪小管断端均成功找到.注水擤鼻法取出鼻泪道引线优于直接夹取法.逆行硅胶管置入有效率达97.01%(65/67),直接硬膜外导管置人有效率达82.14%(23/28),差异有统计学意义(X2=4.06,P<0.05).结论 泪小管断裂吻合术中,硅胶管逆行置入疗效优于硬膜外导管直接置入.注水擤鼻法能快捷取出鼻泪道引线,顺利逆行置入义管,适合在基层医院开展.     

中国北方一先天性白内障家系GJA8基因新突变

目的　对一个中国先天性白内障家系进行分子遗传学研究，并分析其基因型与表型相关性。方法　对该家系采集详细的病历资料，并进行全面的眼科检查，采集外周血并提取DNA。用二代测序方法对可能致病基因进行测序，对发现的变异通过Sanger测序法进行DNA序列分析。结果　在先证者的GJA8基因第二外显子中发现了一个杂合错义突变［c.199G>T］(p.Asp67Tyr)，这一突变也存在于该家系的其他白内障成员中，在正常亲属中未发现相同改变。该家系先证者IV2表现为双眼晶状体全白色混浊，其母III3表现为双眼点状晶状体混浊。结论　在一个中国先天性白内障家系中，发现GJA8基因新致病突变（c.199G>T），拓宽了GJA8基因的突变谱，有助于加深对先天性白内障发病机制的认识。     

2型Usher综合征和视网膜色素变性家系USH2A基因突变及临床表型分析

目的观察2型Usher综合征(USH2)和视网膜色素变性(RP)患者的基因突变型及其临床表型。方法2018年8月至2019年1月于河南省立眼科医院就诊的USH2和RP 3个家系的4例患者和11名正常家系成员纳入研究。详细询问病史并行视力、眼底彩色照相、OCT、视野、全视野ERG检查。3个家系中,家系1为USH2;家系2、3为RP。采集患者及其家系成员外周静脉血,提取全基因组DNA,应用基于靶向捕获的二代测序技术进行基因测序,对可疑致病突变位点通过Sanger进行验证,并在家系成员中进行共分离。结果家系1先证者除眼底有RP表现外,同时合并神经性耳聋。基因检测结果显示,先证者USH2A基因第64、5号外显子分别存在c.13877-13880 del AGAC(p.Q4626P)(M1)、c.798 del T(p.F266L)(M2)2个杂合性移码突变。家系2、3先证者仅有眼底典型RP表现。基因检测结果显示,家系2先证者USH2A基因第70、37、29号外显子分别存在c.15178T>c(p.S5060P)(M3)、c.6986C>A(p.P2329H)(M4)2个杂合性错义突变和c.5836C>T(p.R1946X)(M5)终止突变。家系3先证者USH2A基因第67、57号外显子分别存在c.14951C>T(p.P4984L)(M6)、c.11156G>A(p.R3719H)(M7)2个杂合性错义突变。保守性分析结果显示,USH2A p.Q4626P、p.F266L、p.S5060P、p.P2329H、p.P4984L所对应的氨基酸位点在多个物种中均高度保守。检测出的7个致病突变中,M1~M4、M6为新发现突变位点。结论USH2A基因突变是导致USH2和非综合征性RP的主要原因;不同突变位点影响蛋白质翻译和合成,导致不同临床表型。     

Mutation screening of the GUCA1B gene in patients with autosomal dominant cone and cone rod dystrophy

Background: Heterozygous mutations in GUCA1A (MIM # 600364) have been identified to cause autosomal dominantly inherited cone dystrophy, cone rod dystrophy and macular dystrophy. However, the role of GUCA1B gene mutations in inherited retinal disease has been controversial. We therefore performed a mutation analysis of the GUCA1B gene in a clinically well characterized group of patients of European and North-American geographical origin with autosomal dominantly inherited cone dystrophy and cone rod dystrophy. Material and Methods: Twenty-four unrelated patients diagnosed with cone dystrophy or cone rod dystrophy according to standard diagnostic criteria and a family history consistent with an autosomal dominant mode of inheritance were included in the study. Mutation analysis of all coding exons of the GUCA1B gene was performed by polymerase chain reaction amplification of genomic DNA and subsequent DNA sequencing. Results: Three different sequence variants, c.-17T>C, c.171T>C, c.465G>T were identified. The sequence variant c.465G>T encodes a conservative amino acid substitution, p.Glu155Asp, located in EF-hand 4, the calcium binding site of GCAP2 protein. All sequence variants were previously reported in healthy subjects. Conclusion: The absence of clearly pathogenic mutations in the selected patient group suggests that the GUCA1B gene is a minor cause for retinal degenerations in Europeans or North-Americans.     

Ritleng 泪道插管术治疗结膜炎导致的儿童继发性泪道阻塞疗效观察

目的：探讨 Ritleng 泪道插管术治疗儿童结膜炎继发泪道阻塞的疗效。方法回顾性分析因结膜炎导致继发性泪道阻塞的患儿39例（42只眼）。所有患儿均行 Ritleng 泪道插管术,术后3-6个月拔管,并在拔管后1个月进行随访。以泪道冲洗和 DDT 检查结果最终确定其术后效果。结果患儿39例（42眼）成功置管,拔管后30眼治愈（71％）：泪道冲洗通畅,无流泪症状,DDT 试验阴性;4眼（10％）好转：患儿偶有流泪症状,泪道冲洗存在阻力,DDT 可疑阳性;8眼（19％）无效：拔管后,冲洗泪道不通畅,仍有分泌物、有流泪症状。DDT 阳性。所有患儿42只眼中,共14眼单纯性阻塞,包括4眼为泪小点闭锁;泪小管阻塞为6眼;鼻泪管阻塞有4眼。单纯性阻塞中12眼治愈;1眼好转、1眼无效;共28眼复杂性阻塞,其中18眼治愈,3眼好转,7眼无效。结论对于结膜炎引起的儿童泪道阻塞,Ritleng 泪道插管术存在一定效果,通过该手术可以减少由于未及时手术治疗而出现的不利因素,提高手术成功率。     

婴幼儿先天性鼻泪管阻塞的治疗探讨

目的：探讨不同年龄阶段的先天性鼻泪管阻塞的婴幼儿,在不同时期采取不同的治疗方法。 方法：将87例102眼患儿分成三个不同的年龄段组：第一组：25天龄~3月龄21例26眼;第二组：〉3~7月龄31例36眼;第三组：〉7~24月龄35例40眼。对第一组实行泪囊鼻泪管按摩＋滴眼液治疗;对第二组进行泪道加压冲洗治疗;对第三组施行鼻泪管探通术治疗。 结果：第一组患儿经泪囊鼻泪管按摩＋滴妥布霉素眼液治疗通畅者12眼,治愈率为46.2%;第二组患儿经泪道加压冲洗治疗通畅者33眼,治愈率为91.7%;第三组患儿经鼻泪管探通术治疗通畅者36眼,治愈率为90.0%。第二组和第三组效果明显优于第一组（χ2=15.71,P〈0.01;χ2=15.27,P〈0.01）;第二组和第三组治疗效果无明显差异（χ2=0.02,P〉0.05）。 结论：婴幼儿先天性鼻泪管阻塞应该区分年龄阶段,采取不同的治疗方法,才能获得较好的治疗效果,而泪道加压冲洗是治疗婴幼儿先天性鼻泪管阻塞的首选方式。     

慢性泪囊炎合并泪总管阻塞的手术治疗

目的:探讨慢性泪囊炎合并泪总管阻塞的手术方法及临床效果。方法:慢性泪囊炎合并泪总管阻塞患者46例48眼,全部先有流泪、脓性分泌物病史,直至泪囊区出现硬结,红肿,甚至皮肤溃破,经泪道冲洗检查确诊,行改良泪囊鼻腔吻合联合硅胶管植入术,术后随访3a,定期冲洗泪道,观察手术效果。结果:无流泪、脓性分泌物46眼(96%),泪囊区红肿消失,冲洗泪道通畅。2眼仍有流泪,无脓性分泌物,泪囊区红肿消失,泪道冲洗通畅,有效率100%。结论:改良泪囊鼻腔吻合联合硅胶管植入术一次性解决了鼻泪管泪总管同时阻塞的问题,避免患者再次手术的痛苦,减轻经济负担,是治疗慢性泪囊炎合并泪总管阻塞的有效方法。