PDF(Pubmed)
Abstract：
UNASSIGNED: Surgical punctal occlusion is indispensable for the treatment of severe dry eye in cases where punctal-plug insertion is not applicable due to an enlarged or deformed punctum. However, permanent punctal occlusion is difficult in some cases. In our aim to establish a more reliable punctal occlusion, we have devised a new surgical approach for punctal occlusion.
UNASSIGNED: This study involved 20 puncta of 12 eyes of 12 patients (1 male and 11 females; mean age: 65.2 years) with severe aqueous-tear-deficient dry eye. A new surgical procedure for punctal occlusion using fibrous tissue from under the lacrimal caruncle into the diathermy-induced deepithelialized canaliculus as supporting tissue for punctal closure was performed. In all patients, the assessment of eye symptoms, as well as the condition of punctal occlusion by slit-lamp biomicroscopy, tear volume (tear-meniscus radius [TMR] measurement by meniscometry), the condition of precorneal tear film (graded by interferometry [IG]), measurement of fluorescein breakup time (FBUT), and scoring of ocular surface staining (fluorescein score of area [FSA] and density [FSD], and lissamine green score [LGS]) were performed, and the preoperative and 6-month-postoperative values were compared.
UNASSIGNED: In regard to the postoperative improvement of symptoms, 11 patients showed remarkable improvement, 1 patient showed improvement, and no reopening of the closed punctum was found in any patient. Test values were all significantly improved post surgery (all: P<0.05) as compared to those prior to surgery (respective values [mean ± SD], and the pre- and postoperative P-values were: TMR (mm) [0.18±0.08; 0.56±0.28, P=0.002], IG [4.3±0.9; 2.7±0.8, P=0.009], FBUT [0.4±0.6; 4.1±2.9, P=0.004], FSA [1.6±0.7; 0.7±0.9, P=0.03], FSD [2.7±0.7; 0.6±0.7, P=0.003], and LGS [5.1±2.7; 1.1±2.1, P=0.005]). Moreover, no postoperative complications were observed.
UNASSIGNED: The findings of this study showed that our novel surgical procedure for punctal occlusion is highly successful and that it results in improved and more complete punctal occlusion.
UNASSIGNED: This study involved 20 puncta of 12 eyes of 12 patients (1 male and 11 females; mean age: 65.2 years) with severe aqueous-tear-deficient dry eye. A new surgical procedure for punctal occlusion using fibrous tissue from under the lacrimal caruncle into the diathermy-induced deepithelialized canaliculus as supporting tissue for punctal closure was performed. In all patients, the assessment of eye symptoms, as well as the condition of punctal occlusion by slit-lamp biomicroscopy, tear volume (tear-meniscus radius [TMR] measurement by meniscometry), the condition of precorneal tear film (graded by interferometry [IG]), measurement of fluorescein breakup time (FBUT), and scoring of ocular surface staining (fluorescein score of area [FSA] and density [FSD], and lissamine green score [LGS]) were performed, and the preoperative and 6-month-postoperative values were compared.
UNASSIGNED: In regard to the postoperative improvement of symptoms, 11 patients showed remarkable improvement, 1 patient showed improvement, and no reopening of the closed punctum was found in any patient. Test values were all significantly improved post surgery (all: P<0.05) as compared to those prior to surgery (respective values [mean ± SD], and the pre- and postoperative P-values were: TMR (mm) [0.18±0.08; 0.56±0.28, P=0.002], IG [4.3±0.9; 2.7±0.8, P=0.009], FBUT [0.4±0.6; 4.1±2.9, P=0.004], FSA [1.6±0.7; 0.7±0.9, P=0.03], FSD [2.7±0.7; 0.6±0.7, P=0.003], and LGS [5.1±2.7; 1.1±2.1, P=0.005]). Moreover, no postoperative complications were observed.
UNASSIGNED: The findings of this study showed that our novel surgical procedure for punctal occlusion is highly successful and that it results in improved and more complete punctal occlusion.
摘要：
■在由于泪点扩大或变形而无法插入泪点的情况下，手术泪点闭塞对于治疗严重的干眼是必不可少的。然而,在某些情况下，永久性泪点闭塞是困难的。为了建立更可靠的泪点闭塞，我们设计了一种新的泪点闭塞手术方法。
■这项研究涉及12名患者（1名男性和11名女性；平均年龄：65.2岁）的12只眼中的20个泪点，患有严重的泪液缺乏干眼。进行了一种新的泪点闭塞手术，该手术使用从泪滴下的纤维组织进入透热诱导的深部泪小管作为泪点闭合的支持组织。在所有患者中，眼睛症状的评估，以及裂隙灯生物显微镜检查的泪点闭塞情况，泪液体积(泪液弯月面半径[TMR]通过弯月计测量)，角膜前泪膜的状况（通过干涉法[IG]分级），荧光素分解时间(FBUT)的测量，和眼表染色评分（面积[FSA]和密度[FSD]的荧光素评分，和Lissamine绿色评分[LGS])进行，并比较术前和术后6个月的值。
■关于术后症状的改善，11例患者显着改善，1名患者表现出改善，并且没有发现任何患者重新打开闭合的泪点。与手术前相比，术后测试值均显着改善（均：P<0.05）（相应值[平均值±SD]，术前和术后P值分别为:TMR(mm)[0.18±0.08;0.56±0.28,P=0.002],IG[4.3±0.9;2.7±0.8,P=0.009],FBUT[0.4±0.6;4.1±2.9,P=0.004],FSA[1.6±0.7；0.7±0.9，P=0.03]，FSD[2.7±0.7；0.6±0.7，P=0.003]，和LGS[5.1±2.7；1.1±2.1，P=0.005]）。此外，术后无并发症发生。
■这项研究的结果表明，我们的新型泪点闭塞手术非常成功，并且可以改善和更完全的泪点闭塞。
■这项研究涉及12名患者（1名男性和11名女性；平均年龄：65.2岁）的12只眼中的20个泪点，患有严重的泪液缺乏干眼。进行了一种新的泪点闭塞手术，该手术使用从泪滴下的纤维组织进入透热诱导的深部泪小管作为泪点闭合的支持组织。在所有患者中，眼睛症状的评估，以及裂隙灯生物显微镜检查的泪点闭塞情况，泪液体积(泪液弯月面半径[TMR]通过弯月计测量)，角膜前泪膜的状况（通过干涉法[IG]分级），荧光素分解时间(FBUT)的测量，和眼表染色评分（面积[FSA]和密度[FSD]的荧光素评分，和Lissamine绿色评分[LGS])进行，并比较术前和术后6个月的值。
■关于术后症状的改善，11例患者显着改善，1名患者表现出改善，并且没有发现任何患者重新打开闭合的泪点。与手术前相比，术后测试值均显着改善（均：P<0.05）（相应值[平均值±SD]，术前和术后P值分别为:TMR(mm)[0.18±0.08;0.56±0.28,P=0.002],IG[4.3±0.9;2.7±0.8,P=0.009],FBUT[0.4±0.6;4.1±2.9,P=0.004],FSA[1.6±0.7；0.7±0.9，P=0.03]，FSD[2.7±0.7；0.6±0.7，P=0.003]，和LGS[5.1±2.7；1.1±2.1，P=0.005]）。此外，术后无并发症发生。
■这项研究的结果表明，我们的新型泪点闭塞手术非常成功，并且可以改善和更完全的泪点闭塞。
