| Objective: To observe the intraoperative and postoperative effects of the same RS lacrimal du ct implantation in different operative modes in the treatment of traumatic canalicular laceration.Method: A total of 70 patients(70 eyes)with simple lacrimal canaliculi rupture caused by various injuries were selected from June 2017 to June 2018 in the Second Hospital of hebei medical university eye department.According to the operation mode of RS lacrimal drainage tube implantation during the operation,the patients were divided into two groups: group A and group B.Group A: 35 patients(35 eyes)in all.The operating mode is the same as the direction of conventional lacrimal duct probing.Operation mode for the intraoperative RS lacrimal passage through the lacrimal drainage tube end point,by the temporal side wear a broken end.Then by the end into the lacrimal sac and nasal side rotated 90°after by lacrimal duct probing way into the nasal passages.On the other end in the same way by lacrimal point into the tubular tears.Arriving in lacrimal sac and nasolacrimal duct under nasal catheter.Group B: 35 patients(35 eyes)in all.The operation mode is partially contrary to the direction of conventional lacrimal duct probing.The operation mode of intraoperative RS of lacrimal duct drainage tube at one end to the nasal side of lacrimal duct end into the lacrimal sac and nasolacrimal duct according to explore ways to enter the nasal passages.The other end by the temporal side broken end of lacrimal duct retrograde through the lacrimal point,and then pull out probe RS of lacrimal duct drainage tube by RS again after drainage tube body mark into the probe.At last catheter by lacrimal point into tears tubular,lacrimal sac and nasolacrimal duct to the nasal passages.To observe the incidence rate of lacrimal duct tear during operation and the success rate at 1,3 and 6 months after operation,as well as the incidence of complications such as tear of lacrimal duct,wound dehiscence,eyelid eversion deformity and tear of tear duct of lacrimal duct RS in group A and group B,and analyze the data results.Result:1.Intraoperative lacrimal nodules tear of canaliculus: 6 cases in group A,the incidence rate was 17% and 0 case in group B,the incidence rate was 0%,P=0.012,the difference between the two groups was statistically significant.2.At 1 month after the surgery,Group A: cured 7 cases,improved 23 cases,and the success rate of operation was 86%.Among them,8 cases were tear of lacrimal canaliculus and the incidence rate was 23%,2 cases of wound dehiscence and the incidence rate was 6%,1 case of eyelid eversion deformity and the incidence rate was 3%.Group B: cured 5 cases,improved 27 cases,the success rate of surgery was 91%,including tear of lacrimal canaliculi in 1 case,incidence 3%,wound dehiscence in 1 case,incidence 3%,eyelid eversion deformity in 2 cases,incidence 6%.Compared the operative effect of the two groups,P=0.355,and the difference between the two groups had not statisticalsignificance.Compared the incidence of lacrimal tubule tear in postoperative complications of the two groups,P=0.012,with statisticalsignificance.3.At 3 months after surgery,Group A: cured 28 cases,improved 5 cases,the success rate of surgery was 94%;The lacrimal tubule lacrimal tear occurred in 8 cases(23%),lacrimal dehiscence in 2 cases(6%)and eyelid eversion deformity in 2 cases(6%).Group B: cured 27 cases,improved 7 cases,the success rate of surgery was 97%,including tear of lacrimal canaliculi in 2 cases,incidence 6%,wound dehiscence in 1 case,incidence 3%,eyelid eversion deformity in 2 cases,incidence 6%.The operative effect of the two groups was compared,P=0.500,and the difference had not statisticalsignificance.The incidence of lacrimal tubule tear in postoperative complications of the two groups were compared,P=0.042,with statistical significance.4.At 6 months after the operation,Group A: cured 28 cases,improved 3 cases,the success rate of surgery 89%.The lacrimal tubule tear occurred in 7 cases(20%),lacrimal dehiscence in 0 case(0%)and eyelid eversion deformity in 0 cases(0%).Group B: cured 27 cases,improved 6 cases,the success rate of surgery 94%.Among them,lacrimal duct tear in 2 cases(6%),wound dehiscence in 0 case(0%)and eyelid eversion deformity in 0 cases(0%).The operative effect of the two groups was compared,P=0.337,and the difference had not statisticalsignificance.The incidence of lacrimal tubule tear in postoperative complications of the two groups were compared with P=0.075,with no statistical significance.Conclusion: During the operation,the same RS lacrimal duct was inserted in different operation ways to treat traumatic lacrimal canaliculi fracture,which had no obvious influence on the success rate of the operation.However,the incidence of tear of lacrimal canaliculi during and after surgery can be reduced by placing RS lacrimal drainage tube with intraoperative partial reverse catheterization. |
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