经泪小管980nm激光泪囊鼻腔造孔术临床经验
Experience of transcanalicular 980nm laser-assisted dacryocystorhinostomy
目的 总结分析经泪小管980 nm激光泪囊鼻腔造孔术的临床经验.方法 回顾于2011年4~10月在成都军区总医院眼科经泪小管980 nm激光泪囊鼻腔造孔联合置管术11例,其中单纯鼻泪管阻塞8例,常规泪囊鼻腔吻合术后复发者3例;术后随访4~19个月,记录手术操作情况,观察手术效果和并发症情况.结果 术中骨孔径大小约3 mm,4例次骨孔出口位置不当;取管后8例次冲洗有分泌物,6例次出现泪小管和(或)泪总管狭窄或阻塞;流泪症状明显改善且冲洗通畅者3例.结论 有报道经泪小管980 nm激光泪囊鼻腔造孔联合置管术成功率较高,但需要一定的经验和技巧保证足够大的骨孔及合适的位置,避免泪总管热损伤.
更多Objective To sum up the experience of transcanalicular 980nm laser-assisted dacryocystorhinostomy.Methods Retrospective reviewed 11 cases whom underwent transcanalicular laser-assisted dacryocystorhinostomy combined silicone intubation stenting,including 8 primary nasolacrimal duct obstruction and 3 failed external dacryocystorhinostomy.Follow-up time was 5-17 months.Surgery operation and complication were recorded.Results The size of osteotomys were about 3mm and 4 osteotomys were out of good place.Complications included 8 dacryocystitis,and 6 stenosis or obstruction of lacrimal ductule or common canalicular.Significant improvement of epiphora was achieved in 3 cases at last follow-up.Conclusions The transcanalicular 980nm laser-assisted dacryocystorhinostomy have been reported achieve satisfied success rate.However,experiences are needed for adequate osteotomy size,good location of ostrotomy,avoiding common canalicular thermal injury.
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