The Efficacy Of Different Types Of Silicone Intubation In The Treatment Of Lacrimal Duct Obstruction And Analysis Of Influential Factors To The Prognosis

Objective:To compare the therapeutic efficacy of different types lacrimal duct silicone intubation in the treatment of lacrimal duct obstruction and analyze the influential factors to the prognosis.Methods:Retrospective analysis of 96 cases of 123 eyes with lacrimal duct obstruction treated by lacrimal duct silicone intubation was conducted in our hospital from January 2017 to October 2019.They were divided into the lacrimal duct antegrade catheterization group of 67 eyes and the retrograde catheterization group of 56 eyes.The antegrade lacrimal tube placement group was placed with a U-shaped silicone lacrimal drainage tube(hereinafter referred to as U tube)produced by Shandong Furuida Medical Devices Co.,Ltd.,and the retrograde tube group was placed with "Y" type lacrimal duct retractable drainage tube(hereinafter referred to as B tube)produced by Yang Zhong Meidi Silicone Medical Products Co.,Ltd.,Follow-up observations for 3-24 months after extubation were made on the functional prognosis(i.e.subjective symptoms)and anatomical prognosis(i.e.lacrimal irrigation results)of the patients,and the functional prognosis and anatomical prognosis of the two groups at different obstruction sites.Statistical t test,χ2 test and/or MannWhitney U test were used to compare the difference in efficacy.Logistic regression analysis was performed on factors such as gender,age,course of disease,time of intubation,times of lacrimal tract irrigation,assisted micro-drilling lacrimal plasty and mucinous secretion to determine the factors affecting the efficacy.Results:The postoperative anatomical effective rate in the U tube group and the B tube was 86.57% and 82.14%,respectively,with statistically significant differences(Z=-1.985,P=0.047).The postoperative of functional effective rate of the U tube group was 85.07% and 82.14% in the B tube group,which has significant differences(Z=-2.012,P=0.044).The functional effective rate and anatomical effective rate of the U tube group and the B tube group did not have statistically significant differences(P>0.05)in different obstructive positions.Univariate analysis was performed on the potential factors affecting the efficacy,and the course of the disease was significantly different(t = 2.552,P = 0.011).No statistically significant differences(P>0.05)were identified in age,gender,catheter intubation time,auxiliary microdrill of dacryocystoplasty and mucinous secretion.Logistic multiple regression analysis was performed and the course of disease(P=0.004,OR=0.524,95%CI [0.336,0.817])and mucinous secretion(P=0.044,OR=0.222,95%CI [0.051,0.957])were independent factors affecting the postoperative efficacy.Conclusion:Both two types of lacrimal duct silicone intubation were effective in treating lacrimal duct obstruction.The long-term functional and anatomical prognosis of the antegrade catheter(U-tube group)is higher than that of the retrograde catheter(Btube group).The course of disease and mucinous secretion were independent factors affecting the postoperative efficacy.