泪道探通联合眼膏灌注治疗先天性鼻泪管阻塞

目的评价对患先天性鼻泪管阻塞的1岁内婴儿施行泪道探通术联合泪道内灌注氧氟沙星眼膏的临床效果。方法因持续性泪溢、泪道冲洗不通,经泪囊区局部按摩无效而被确诊为先天性鼻泪管阻塞的1岁内婴儿60例(67眼),在局麻下施行泪道探通术,并注入泪道以甲基纤维素为赋形剂的氧氟沙星眼膏,术后点滴氧氟沙星眼水1wk。分别于术后3,7d进行泪道冲洗,随访3mo,观察其临床症状的改善情况。结果所有60例(67眼,100%)通过1～3次的治疗均获临床治愈。其中,1次治愈64眼,治愈率95.5%(64/67);2例(2眼)在首次术后3d因冲洗泪道不通而再次手术后获治愈(3%,2/67);1例1眼)则连续进行了3次手术方获治愈(1.5%,1/67)。无1例造成假道,唯一常见的并发症是在9例(10眼,14.9%)术后鼻腔分泌物中见少许血染。结论对不满1岁的婴儿在局麻下施行鼻泪管探通术联合氧氟沙星眼膏灌注治疗其先天性鼻泪管阻塞是十分安全、简捷而有效的方法。

Lacrimal duct probing followed by ofloxacin ointment irrigation in infants with congenital nasolacrimal duct obstruction

·AIM:To evaluate the effects of lacrimal duct probing followed by irrigation with ofloxacin based on methylcellulose on infants younger than 1 year old with epiphora,due to congenital nasolacrimal duct obstruction (CNLDO).·METHODS: After the failure of regular lacrimal sac massage,60 infants (67 eyes) under 1 year old with persistent epiphora and impeded lacrimal drainage system underwent routine lacrimal duct probing followed by irrigation with ofloxacin based on methylcellulose under topic anesthesia.Lacrimal duct rinsing was performed on 3d and 7d.The percentage of eyes which showed complete resolution of symptoms 3mo after the final probing was calculated.·RESULTS:All of the 67 lacrimal systems (100％) had complete resolution of symptoms and unimpeded lacrimal drainage systems after 1-3 times of probe.The cure rate was 95.5％ after the first probe,with 2 cases (2 eyes,about 3％) been treated twice and 1 case (1 eye, 1.5％) 3 times.Common complication included slight bloodstained nasal discharge in 9 cases (10 eyes,14.9％).·CONCLUSION:Under topical anesthesia,lacrimal duct probing followed by irrigation with ofloxacin ointment is a safe,easy and efficient treatment for CNLDO in infants with minimal complications.