| Purpose: To investigate the applicability of tear meniscus height(TMH) measurement using Visante optical coherence tomography(OCT), to evaluate the efficacy of functional endoscopic dye test(FEDT) and measurement of ostium area(OA) after dacryocystorhinostomy. To investigate the correlations between the values of the Munk score(MS), the TMH, the FEDT and the OA.Methods: The control group included Thirty-four eyes of 34 healthy people without tearing. The observation group included Forty-seven eyes from 47 patients with nasolacrimal duct obstruction who received en-DCR from April 2015 to September 2015 were evaluated prospectively on their TMH changes both before and after surgery by Visante-OCT. The observation group has been divided into epiphoral group(MS?2) and no epiphoral group(MS<2) based on their clinical symptoms at 1-6 months(1-6M) after surgery. The values of the FEDT, TMH, MS and OA were measured 1 months(1M),2 months(2M), 3 months(3M),and 6 months(6M) after surgery. Then, related factors were compared and analyzed.Results: The preoperative values of the TMH and MS were 0.34±0.03 mm and 1.0±0.73, respectively, the correlation coefficient were 0.95 in the control group. The preoperative values of the TMH and MS were 0.66±0.04 mmm, 4.28±0.62, respectively, the correlation coefficient were 0.85 in the observation group. Compared with the control group,the differences were statistically significant. The postoperative values of TMH in the observation group were 0.41±0.03 mm, 1 month after surgery,0.51±0.04 mm,2 month after surgery, 0.50±0.04 mm,3 month after surgery, 0.44±0.03 mm,6 month after surgery. At each follow-up, the postoperative values of the TMH decreased significantly compared to its preoperative values in the observation group. Among them, The postoperative values of TMH in the no epiphoral group decreased significantly compared to its preoperative values at each follow-up. The postoperative values of TMH in the epiphoral group decreased significantly compared to its preoperative values at 1 month after surgery, however, there were no differences from 2 month after surgery. The differences for the values of TMH were no statistically significant between the epiphoral group and the no epiphoral group at 1 month after surgery. But the differences were significant since 2 month after surgery.The postoperative values of FEDT in the no epiphoral group were 14.86±3.3 seconds, 1 month after surgery,22±5.031 seconds,2 month after surgery, 20.14±3.7 seconds,3 month after surgery, 16.85±4.46 seconds,6 month after surgery. The postoperative values of OA in the no epiphoral group were 13.31±3.79mm~2,1 month after surgery, 4.77±2.82mm~2mm~2,2 month after surgery, 6.16±2.57mm~2,3 month after surgery, 5.47±3.72mm~2, 6 month after surgery. The postoperative values of FEDT in the epiphoral group were 44±3.67 seconds,1 month after surgery, 120.22±34.54 seconds,2 month after surgery, 62.89±7.90 seconds,3 month after surgery, 54.40±8.20 seconds, 6 month after surgery. The postoperative values of OA in the epiphoral group were 3.81±2.16mm~2,1 month after surgery, 1.55±0.35mm~2,2 month after surgery, 1.57±0.80mm~2,3 month after surgery, 1.42±0.92mm~2, 6 month after surgery. The values of the FEDT and the TMH for patients in the observation group, epiphoral group and no epiphoral group have reached the lowest point at 1 month after surgery, and have achieved the highest point at 2 month after surgery, then, have decreased up from 3 month to 6 month after surgery. However, The values of the OA for the three groups were biggest at 1 month after surgery, and were lowest at 2 month after surgery, have rised up to 3 month after surgery, then, were maintained at constant values thereafter.There were statistically significant differences for the values of FEDT and the OA between the epiphoral group and the no epiphoral group. At each follow up, the TMH correlated positively with the FEDT, the OA correlate negatively with the TMH and the FEDT, there were statistically significant associations in the observation group. In the no epiphoral group, the TMH showed a positive correlation with the FEDT, the OA correlate negatively with the TMH and the FEDT, the associations were statistically significant at 2 month after surgery. In the remaining months, the associations were not statistically significant. In the epiphoral group, the TMH showed a positive correlation with the FEDT, the OA correlate negatively with the TMH and the FEDT, the associations has statistical significance at 1 to 3 month after surgery. In the 6 month after surgery, the associations were no statistically significant.Conclusion: Visante-OCT can be used to evaluate the TMH in patients with PANDO who received en-DCR with the good accuracy and repeatability. The TMH has a positive correlation with the MS. The values of the FDDT, the TMH and the OA for both the epiphoral group and the no epiphoral group have changed obsversly from 1to 3month after surgery and were maintained at constant values from 3 to 6 month after surgery. 1-3 month after surgery is the most important period for follow-up observation. At each follow up, The TMH has a positive association with the FEDT and has a positive association with the TMH and the FEDT. All of them were good indexes to evaluate the successful rate of the en-DCR. |
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