| OBJECTIVE: To investigate the influence of the high-frequency electrolacryocystoplasty surgery combined artificial nasolacrimal duct implantation on the ocular surface function,bacterial spectrum of conjunctival sac in patients with chronic dacryocystitis.METHODS: Thirty-one patients(32 eyes)diagnosed as chronic dacryocystitis were consecutive enrolled in the Department of Ophthalmology,the Fifth Affiliated Hospital of Southern Medical University from January 2015 to June 2016.The patients underwent high-frequency electrolacryocystoplasty surgery combined reverse artificial nasolacrimal duct implantation respectively assessed the ocular surface before treatment,1 week,1 month after surgery,1 week after extubation.Patients were evaluated by dry eye questionnaires,corneal fluorescein staining test,tear secretion test,tear break-up time measurement,total tear protein determination and conjunctival sac bacterial culture,and discussed the influence of the high-frequency electrolacryocystoplasty surgery combined artificial nasolacrimal duct implantation on the ocular surface function,bacterial spectrum of conjunctival sac in patients with chronic dacryocystitis.RESULTS: The numbers of patients who completed follow-up were 31 cases(32eyes).1.The questionnaire surveys showed the patients with electrolacryocystoplasty surgery combined artificial nasolacrimal duct implantation were significantly reduced in tears,secretion and discomfort.There were no significant difference between preoperative,postoperative groups and different age groups(P > 0.05).2.The scores of corneal fluorescein staining before surgery,1 week after surgery,1month after surgery and 1 week after extubation were: 0.22 ±0.49 points,0.25 ±0.51 points,0.51 ±0.40 points,0.25 ±0.44 points respectively.There was no significant difference between preoperative,1 week,1 month and 1 week postoperative groups and 1 week after extubation,no statistical significance(P > 0.05),and no significant difference in preoperative and postoperative between different age groups(P > 0.05).3.The measures of tear break-up time before surgery,1 week after surgery,1 month after surgery and 1 week after extubation were: 9.63 ±2.69 seconds,9.44 ±2.23 seconds,2.23 ±2.39 seconds,9.34 ±2.54 seconds respectively.There was no statistical significance(P > 0.05)between postoperative three time points and preoperative groups,and no significant difference between different age groups(P > 0.05).4.The results of tear secretion test before surgery,1 week after surgery,1 month after surgery and 1 week after extubation were: 12.56 ±6.02 mm,6.02 ±5.86 mm,13.56±6.02 mm,6.02 ±6.35 mm respectively.Compared with postoperative three time points and preoperative groups: there was statistically significant difference between 1week after surgery and before surgery(P < 0.05);no statistical significance between 1month after surgery,1 week after extubation and before surgery(P > 0.05).At 1 week after surgery,the secretion of lacrimal fluid increased,and after 1 month after surgery and 1 week after the removal of the tube,it was reduced to the normal level and no significant difference(P > 0.05).There was no significant difference between the different age groups(P > 0.05).5.The determinations of total tear protein content at before surgery,1 week after surgery,1 month after surgery and 1 week after extubation were: 8.48 ±0.44 mg/ml,11.27 ±0.78 mg/ml,8.37 ±0.50 mg/ml,0.50 ±0.60 mg/ml respectively.Compared with postoperative three time points and preoperative: there was statistically significant difference between 1 week after surgery and before surgery(P < 0.05);no statistical significance between 1 month after surgery,1 week after extubation and before surgery(P > 0.05).At 1 week after surgery,the total protein content of lacrimal fluid increased significantly,which tended to be stable after 1 month after operation,no significant difference between 1 week after extubation and before operation.Therewas no significant difference between the different age groups.6.The positive rate of conjunctival sac bacterial culture(means positive bacteria growth): a total of 32 eyes,preoperative germiculture positive was 27 eyes,positive rate was 84.375%,1 week after extubation conjunctival sac germiculture positive was7 eyes,positive rate was 21.875%.The rate of bacterial culture of conjunctival sac was significantly decreased after high-frequency electrolacryocystoplasty surgery combined artificial nasolacrimal duct implantation.There was statistically significant difference between 1 week after extubation and before surgery(P < 0.05)Conclusion: High-frequency electrolacryocystoplasty surgery combined artificial nasolacrimal duct implantation does not significantly affect corneal fluorescein staining,tear secretion test,tear break-up time and total tear protein.Ocular surface funciton in patients with chronic dacryocystitis,however,can obviously improve the patient's symptoms of epiphora,increased secretion and discomfort,and significantly decrease conjunctiva sac germiculture positive rate,thus reduce the risk of eye infection,and worthy of clinical popularization. |
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