CAJ | 학술논문

目的探讨手术显微镜下应用小梁咬切器行泪点咬切成形和联合双泪小管置管术治疗泪点膜覆盖及泪点膜闭的效果.方法 36例(48眼)泪点膜覆盖和泪点膜闭,按照泪点膜的基底部占泪点口径圆周的范围由小到大分为4组,第1组8例(9眼),采用小梁咬切器在显微镜下行单纯泪点咬切成形术;第2组16例(23眼);第3组7例(9眼);第4组5例(7眼).第2、3、4组采用小梁咬切器咬切成形联合双泪小管人工泪管置管术.3个月后拔除人工泪管,拔管后随访6 ～12个月.结果 4组均取得了较为良好的效果,溢泪症状完全消失者30例(42眼),占87.5％;好转4例(4眼),占8.3％;无效2例(2眼),占4.2％.其中第1组治愈7例(8只眼),占88.8％,好转1例(1眼),无无效病例.第2、3、4组共治愈24例(34眼)占87.1％,好转各组1例(1眼)共3例(3眼),第3组、第4组无效各1例(1眼).结论手术显微镜下应用小梁咬切器行泪点咬切成形术和必要时联合双泪小管人工泪管置管术是治疗泪点膜覆盖及泪点膜闭的一种损伤小、疗效好、成功率高的方法.
목적 탐토수술현미경하응용소량교절기행루점교절성형화연합쌍루소관치관술치료루점막복개급루점막폐적효과.방법 36례(48안)루점막복개화루점막폐,안조루점막적기저부점루점구경원주적범위유소도대분위4조,제1조8례(9안),채용소량교절기재현미경하행단순루점교절성형술;제2조16례(23안);제3조7례(9안);제4조5례(7안).제2、3、4조채용소량교절기교절성형연합쌍루소관인공루관치관술.3개월후발제인공루관,발관후수방6 ～12개월.결과 4조균취득료교위량호적효과,일루증상완전소실자30례(42안),점87.5％;호전4례(4안),점8.3％;무효2례(2안),점4.2％.기중제1조치유7례(8지안),점88.8％,호전1례(1안),무무효병례.제2、3、4조공치유24례(34안)점87.1％,호전각조1례(1안)공3례(3안),제3조、제4조무효각1례(1안).결론 수술현미경하응용소량교절기행루점교절성형술화필요시연합쌍루소관인공루관치관술시치료루점막복개급루점막폐적일충손상소、료효호、성공솔고적방법.
Objective To evaluate the efficiency of microsurgical punctoplasty by using trabeculectomy punch or combined with bicanalicular stent intubation in patients with punctal membranes.Methods 36 patients (48 eyes) with partial or entire punctal membranes were distributed into 4 groups based on the proportion of basal part of the membrane to the circumference of lacrimal punctum from small to big.Group 1 (8 patients,9 eyes) underwent a microsurgical punctoplasty using a trabeculectomy punch,while group 2 (16 patients,23 eyes),group 3 (7 patients,9 eyes),and group 4 (5 patients,7 eyes) underwent a punctoplasty combined with insertion of self-retaining bicanalicular stents.These tubes were removed at 3 months after the operation.A follow-up of 6 to 12 months was taken for final analysis.Results Of all the four groups,30 patients (42 eyes,87.5％) had complete epiphora relief,4 patients (4 eyes,8.3％) had partial relief and 2 patients (2 eyes,4.2％) had no improvement after the removal of the tubes.In group 1,complete resolution of symptoms and signs was noted in 7 patients (8 eyes,88.8％),and there was no ineffective case but 1 patient (1 eye) of partial relief.While in group 2,3 and 4,24 patients (34 eyes,87.1％) had complete relief from epiphora,1 patient (1 eye) of each group had partial relief,and 1 patient (1 eye) of group 3 and group 4 respectively had no improvement after the procedure.Conclusion Microsurgical punctoplasty by using trabeculectomy punch or combined with bicanalicular stent intubation when necessary can be an effective and minimally invasive treatment for punctal membrane.