The Clinical Efficacy And Experience Of New Retrograde Lacrimal Duct Catheterization For Treatment Of Lacrimal Duct Obstruction Diseases

Objective:The aim of this study was to investigate the clinical efficacy and experience of the new retrograde lacrimal duct catheterization in the treatment of lacrimal duct obstructive diseases.Methods:Collected from March 2012 to June 2016 in the First Affiliated Hospital of Dalian Medical University,three ophthalmology diagnosed with lacrimal duct obstruction in 72 cases of 77 cases,aged 31 to 76 years,the median age of 56 years,duration of 6 months?20 years,the median duration of 48 months,including male patients in 19 cases of 20 eyes,53 cases of female patients 57 cases,male:female = 1:2.74,28 cases of right eye alone,39 cases of left eye disease alone,eyes Sick in 5 cases.Including simple tubule obstruction in 6 cases of 7 eyes(with lacrimal duct stones 1 eye);simple lacrimal duct obstruction in 10 patients in 11 cases;nasolacrimal duct obstruction in 39 cases of 41 eyes;lacrimal duct obstruction with nasolacrimal duct obstruction in 9 cases 10 eyes;lacrimal duct obstruction with nasolacrimal duct obstruction in 8 cases of 8 eyes.32 patients with chronic dacryocystitis were treated with 38 eyes,including 2 cases of 2 cases of dacryocystoracic cyst and 2 cases of lacrimal sac fistula after acute dacryocystitis.Were treated with a new type of retrograde lacrimal duct catheterization,the first day after the start with gentamicin sodium chloride injection rinse lacrimal duct,1 day,rinse for 1 week;then rinse the lacrhea once a week,Rinse 4 weeks;continue to wash the lacrimal passage once a month to extubation;postoperative levofloxacin eye drops 4 times a day drops of eye drops,levofloxaciri hydrochloride eye gel before going to bed once a day coating the conjunctival sac 4 weeks,depending on the condition to decide whether to continue medication;according to the specific circumstances of patients,3 months after the removal of catheterization,rinse the lacrimal rinse once a month after the disease is stable after elective lacrimal rinse,after extubation follow-up observation 3 to 24 months.After the last follow-up,the lacrimal rupture was combined with the improvement of the condition of the tearfulness as the evaluation criteria.The generalization was effective and ineffective,including the cure and confirmation.Results:1.A total of 72 cases of 77 cases of surgery,of which 71 cases of 76 cases of surgical procedures were smooth,1 case of 1 operation failed,the success rate of 98.70%.The total effective rate was 92.1%,including 53 cases(56 eyes)during the postoperative follow-up period.Rinse smooth,all at the last referral that no obvious tearing symptoms,the cure rate of 73.68%;12 cases of 14 cases of lacrimal duct flushing patency,but with a certain resistance when washing,and can see a small amount of reflux fluid,reflux fluid no obvious Secretions,at the last referral that even occasional indoor tears,markedly effective rate of 18.42%.3.6 cases of 6 eyes,lacrimal duct obstruction recurrence,the efficiency was 7.90%,of which 5 cases were accompanied by varying degrees of chronic dacryocystitis.4.Comparison of different types of lacrimal duct obstruction surgery x2 value of 5.077,P = 0.279,that different types of lacrimal duct obstruction surgery between the effective rate of no statistical interest.5.The curative effect of ?2 was 2.895,P = 0.089,and the difference was not statistically significant.Conclusion:1.The new type of lacrimal duct retrograde catheter with a special lacrimal duct probe to the lacrimal drainage tube from the hidden nasolacrimal canal mouth into the lacrimal duct,effectively solve the difficulties in the previous catheter surgery,surgery High success rate.2.New type of lacrimal duct retrograde catheterization with follow-up lacrimal rinse,simple operation and less postoperative complications,the lacrimal duct obstruction and chronic dacryocystitis has a positive effect,is a widely promoted lacrimal duct minimally invasive therapy.3.Preoperative strict control of surgical indications and the elimination of related diseases is a necessary condition for successful operation.There was no significant difference in the curative effect between different types of lacrimal duct obstruction after operation and need to be further expanded.4.There was no statistically significant difference in the efficacy of different types of lacrimal duct obstruction after surgery,and further study was needed to expand the sample.5.There were more cases of postoperative recurrence of lacrimal duct obstruction in patients with chronic dacryocystitis before operation,but the difference was not statistically significant,and further study was needed to expand the sample.6.The surgical method of chronic dacryocystitis caused by the treatment of dacryocystorcystitis is poor,for such patients should consider other surgical treatment.