| 引用本文： |
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张 娟,高佳妮,王桑桑,等.改良泪点成形术治疗下泪点狭窄的临床研究[J].同济大学学报（医学版）,2019,40(2):225-229. [点击复制]
- ZHANG Juan,GAO Jia-ni,WANG Sang-sang,et al.Efficacy of modified punctoplasty for severe lower punctual stenosis[J].同济大学学报（医学版）,2019,40(2):225-229. [点击复制]
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| 摘要: |
| 目的 探讨改良泪点成形术治疗下泪点狭窄的临床效果。方法 收集32例（50眼）下泪点狭窄或闭锁的患者行改良泪点成形术，术中以原泪点起始，分别向鼻侧做水平及向内壁做垂直方向的修剪放大。术后随访观察（10.1±4.8）个月。以眼前节光学相干断层扫描仪（anterior segment optical coherence tomography, AS-OCT）测量泪点横径（punctum diameter, PD）、泪河高度(tear meniscus height, TMH)；并行Munk评分。结果 所有手术均顺利实施。术前及术后1周、1个月、6个月，下泪点横径分别为（140.65±121.34）、（676.25±53.30）、（699.30±62.61）、（657.75±58.36）μm，差异均有统计学意义（t=-17.92，P＜0.05；t=-19.53，P＜0.05；t=-20.24，P＜0.05）；泪河高度分别为（573.85±108.99）、（309.55±57.82）、（264.08±50.28）、（280.65±40.53）μm，差异均有统计学意义（t=11.67，P＜0.05；t=11.87，P＜0.05；t=10.342，P＜0.05）；Munk评分分别为3.70±0.47、0.55±0.69、0.20±0.41、0.15±0.37，差异均有统计学意义（t=14.26，P＜0.05；t=20.07，P＜0.05；t=23.13，P＜0.05）。术后第1天，患者的溢泪症状较术前明显改善。结论 改良泪点成形术能有效扩大泪点，改善溢泪。 |
| 关键词: 泪点成形术 光相干断层扫描 溢泪 泪河高度 泪点横径 |
| DOI：10.16118/j.1008-0392.2019.02.017 |
| 投稿时间：2018-08-01 |
| 基金项目:上海市申康医院发展中心-三年行动计划（16CR3027A）；上海市科技创新行动计划（16140900900） |
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| Efficacy of modified punctoplasty for severe lower punctual stenosis |
| ZHANG Juan,GAO Jia-ni,WANG Sang-sang,NIU Guo-zhen,HUANG Xin-yu,BI Yan-long |
| (Dept. of Ophthalmology, Tongji Hospital, Tongji University, Shanghai 200065, China) |
| Abstract: |
| Objective To evaluate the safety and efficacy of modified punctoplasty for severe lower punctual stenosis. Methods Thirty-two patients (50 eyes) with severe lower punctual stenosis underwent modified canaliculus-membranes-sparing punctoplasty. The horizontal and vertical apartment of the inner wall of the punctum was enlarged during the surgery. Patients were followed up for 10.1±4.8 months. Lower punctum diameter (PD), tear meniscus height (TMH) were measured by anterior segment optical coherence tomography（AS-OCT）and Munk scores was assessed. Results All the procedures were performed successfully. The PD was （140.65±121.34）μm before surgery, （676.25±53.30）μm 1 w after surgery (t=-17.92, P＜0.05), （699.30±62.61）μm 1 mouth after surgery (t=-19.53, P＜0.05) and （657.75±58.36）μm 6 mouths after surgery (t=-20.24, P＜0.05); meanwhile the TMH was （573.85±108.99）, （309.55±57.82）μm (t=11.67, P＜0.05), （264.08±50.28）μm (t=11.87, P＜0.05), （280.65±40.53）μm (t=10.342, P＜0.05), at the same time points respectively. There was significant improvement in symptoms after operation，as measured subjectively by Munk scores. The Munk scores before surgery and 1 week，1 mouth and 6 mouths after surgery were 3.70±0.47, 0.55±0.69 (t=14.26, P＜0.05), 0.20±0.41 (t=20.07, P＜0.05), 0.15±0.37 (t=23.13, P＜0.05) respectively. The subjective epiphora score was reduced after surgery and stayed stability until 1 mouth after surgery. Conclusion Modified punctoplasty is a convenient and effective procedure for severe lower punctal stenosis. |
| Key words: punctoplasty optical coherence tomography epiphora tear meniscus height punctum diameter |
