| Chronic dacryocystitis is a common and frequently-occurring eye disease. The clinical manifestations of chronic dacryocystitis are epiphora and pyorrhea, which can bring great discomfort and pain to the patient's life, work and psychological. Chronic dacryocystitis is a potential source of infection. Once the patients suffer from intraocular surgery and trauma, the eyes are very easy to cause pyogenic infection.The key for the treatment of chronic dacryocystitis is to unchoke or rebuild lacrimal passage, and recover the function of lacrimal passage. There are a lot of therapies for the treatment of chronic dacryocystitis, for example, dacryocystorhinostomy that is the traditional surgical method. Because the dacryocystorhinostomy has the characteristics of operation complex, large damage, more bleeding, change the normal lacrimal duct structure, postoperative facial leave scar and affect the appearance, most of patient, especially women, can't accept it. With the development of new technology and new material, minimally invasive surgeries, such as laser dacryocystoplasty, laser recanalization under lacrimal endoscope and lacrimal duct intubation, are widely applied to clinical. Because they have the characteristics of good curative effect, wide indications, few damage, few complications, doesn't change the normal lacrimal duct structure and affect the appearance, they are very easy to be accepted by people. Now it is a trend of minimally invasive surgeries instead of dacryocystorhinostomy for the treatment of chronic dacryocystitis.ObjectiveTo assess the clinical effect and complication rate of lacrimal endoscopy and dacryocystoplasty combined with intubation for the treatment of chronic dacryocystitis with lacrimal duct stenosis or obstruction.MethodsFrom July 2014 to December 2014, 89 eyes of 82 cases diagnosed as chronic dacryocystitis with lacrimal duct stenosis or obstruction who were selected as objects in the Ophthalmology Department of The First Affiliated Hospital of Zhengzhou University. They were randomly divided into endoscopic treatment group(endoscopic dacryocystoplasty combined with intubation treatment group, 45 eyes of 41 cases)and laser treatment group(dacryocystoplasty combined with intubation treatment group, 44 eyes of 41 cases). The follow-up time was 6 months, and the tubes were kept in place for 6 months after operation. The clinical effect and complications of two groups were observed and compared.Results1. Clinical effect analysis:(1)Endoscopic treatment group: There were 40 eyes recovered(88.89%), 3eyes improved(6.67%) and 2 eyes invalid(4.44%).(2)Laser treatment group: There were 38 eyes recovered(86.36%), 4 eyes improved(9.09%) and 2 eyes invalid(4.55%).(3)Clinical effect statistical analysis: There was no statistical difference in the clinical effect of two groups(z=-0.345, P=0.730).2. Complication:(1) Endoscopic treatment group: A total of 7 eyes appeared complications(15.55%), 2 eyes appeared lacrimal duct hyperplasia of granulation(4.44%), 1 eye appeared tears tear(2.22%), 1 eye appeared palpebral edema(2.22%), 3 eyes appeared ball head silicone abjection(6.67 %).(2)Laser treatment group: A total of 18 eyes appeared complications(40.91%),2 eyes appeared puncta lacrimalis(4.55%), 6 eyes appeared lacrimal duct hyperplasia of granulation(13.64%), 3 eyes appeared tears tear(6.82%), 1 eye appeared palpebral edema(2.27%), 5 eyes appeared ball head silicone abjection(11.36%), 1 eye appeared lead-type silicone abjection(2.27%).(3)Complication rate statistical analysis: There was statistical difference in complication rate of two groups(?2=7.080, P=0.008).ConclusionsIt is effective for patients who are diagnosed as chronic dacryocystitis with lacrimal duct stenosis or obstruction to be treat by lacrimal endoscopy and dacryocystoplasty combined with intubation. The former can clearly observe lacrimal duct obstruction site and directly operate, besides, it has the characteristics of few damage, few complications and good curative effect, so it is worthy for clinical application. |
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