| Background:As a common ophthalmic disease in middle-aged and older women,the symptoms of chronic dacryocystitis are tears and pus,which not only affect the appearance of patients but also lead to a variety of ocular complications.The key to treat chronic dacryocystitis is to eliminate inflammation and restore the function of lacrimal duct drainage.The dacryocystorhinostomy is a traditional treatment with positive efficacy.Due to the complex operation,long operation time,intraoperative bleeding,facial scars,and other shortcomings,most patients are challenging to accept the dacryocystorhinostomy.It is difficult to carry out in grass-roots hospitals.Due to the development of interventional technology and the emergence of new materials,the treatment of chronic dacryocystitis updateds rapidly.Nasolacrimal duct stent implantation has the function of dilating the obstruction and supporting the nasolacrimal duct by implanting a stent in nasolacrimal duct.It has the advantages of simple operation,fast time-consuming,a high success rate of operation,minor trauma,and no scar.It is also suitable to be carried out in hospitals at all levels.There are many kinds of nasolacrimal duct stents used in practice,such as a metal tube,silicone tube,polyurethane stent,epidural anesthesia catheter,and various self-made nasolacrimal duct stents,but reports on the efficacy are different.It often occurs postoperative complications such as stent dislocation and re-obstruction.Therefore,it is vital to use a type of stent which is consistent with the physiological structure and has a reliable efficacy.Objective:To compare the efficacy among a T-type of Teflon nasolacrimal duct stent and a V-type of epidural anesthesia catheter in the treatment of chronic dacryocystitis.To explore the value of a T-type of Teflon nasolacrimal duct stent on chronic dacryocystitis.Methods:This randomized clinical trial was performed to compare success rate of intubation,time used for stent implantation,intraoperative pain,and incidence of puncta injury between a T-type of Teflon nasolacrimal duct stent implantation(observation group)and a V-type of epidural anesthesia catheter implantation(control group)in the treatment of chronic dacryocystitis.To observe the efficacy,improvement of ocular symptoms,and extubation-associated complications three moths after the operation.Results:1.A total of 80 patients(94 eyes)were enrolled in this trial.The cure rate was91.7%(44/48),the improvement rate was 8.3%(4/48),and the ineffective rate was 0 at one week after the operation in the observation group.The cure rate was 87.0%(40/46),the improvement rate was 10.9%(5/46),and the ineffective rate was 2.1%(1/46)at one week after the operation in the control group.There was no significant difference in efficacy between the two groups(Z=-0.765,P=0.445,P>0.05).In the observation group,the cure rate was 87.5%(42/48),the improvement rate was 10.4%(5/48),and the ineffective rate was 2.1%(1/48)at one month after the operation.In the control group,the cure rate was 69.6%(32/46),the improvement rate was 21.7%(10/46),and the ineffective rate was 8.7%(4/46)at one month after the operation.There was a significant difference in efficacy between the two groups(Z=-2.154,P=0.031,P<0.05).In the observation group,the cure rate was 77.1%(37/48),the improvement rate was14.6%(7/48),the ineffective rate was 8.3%(4/48)at three months after the operation.In the control group,the cure rate was 56.5%(26/46),the improvement rate was 28.3%(13/46),and the ineffective rate was 15.2%(7/46)at three months after the operation.There was a significant difference in efficacy between the two groups(Z=-2.057,P=0.040,P<0.05).There was no significant difference in efficacy at one week,one month,and three months after the operation in the observation group(H=4.734,P=0.091,P>0.05).There was a significant difference in efficacy at one week,one month,and three months after the operation in the control group(H=10.844,P=0.004,P<0.05).2.There was no significant difference in the score of ocular symptoms between the observation group and the control group before the operation[(14.2±2.1)vs(14.3±2.0),t=-0.222,P=0.824,P>0.05].They were significantly lower than before at three months after the operation[(3.4±1.9)vs(5.0±2.3),P=0.000,P<0.05],and the score of the observation group was lower than the control group(t=-3.882,P=0.000,P<0.05).3.The total success rate of sent implantation was 100%(94/94).The patients in the observation group and control group were successfully implanted.4.The median time used for sent implantation was significantly different between the observation group and the control group(12.0s vs 15.5s,Z=-2.096,P=0.036,P<0.05).5.There was no significant difference in intraoperative pain between the observation group and the control group(2.0cm vs 2.0cm,Z=-0.165,P=0.869,P>0.05).6.The incidence of puncta injury was 35.4%(17/48)in the observation group and45.7%(21/46)in the control group.There was no significant difference between the two groups(c~2=2.022,P=0.312,P>0.05).7.The incidence of extubation-associated complications was 10.4%(5/48)in the observation group and 8.7%(4/46)in the control group.There was no significant difference between the two groups(Fisher’s Exact Test,P=1.000,P>0.05).The incidence of breakage was 6.3%(3/48)in the observation group and 2.2%(1/46)in the control group.There was no significant difference between the two groups(Fisher’s Exact Test,P=0.617,P>0.05).8.The incidence of stent-related complications was 16.7%(8/48)in the observation group and 30.4%(14/46)in the control group.There was no significant difference between the two groups(c~2=2.484,P=0.115,P>0.05).The incidence of stent dislocation was 0%(0/48)in the observation group and 13.0%(6/46)in the control group.There was a significant difference between the two groups(Fisher’s Exact Test,P=0.012,P<0.05).Conclusion:1.The efficacy of a T-type of Teflon nasolacrimal duct stent is better and more stable than a V-type of epidural anesthesia catheter in the treatment of chronic dacryocystitis.2.A T-type of Teflon nasolacrimal duct stent has the advantages of shorter intubation time and fewer complications in the treatment of chronic dacryocystitis compared with a V-type of epidural anesthesia catheter.3.A T-type of Teflon nasolacrimal duct stent implantation is a safe method which can be widely used for treating chronic dacryocystitis. |
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