Abstract：
OBJECTIVE: To compare endonasal dacryocystorhinostomy (EN-DCR) with sheath-guided dacryoendoscopic probing and bicanalicular intubation (SG-BCI) by evaluating tear meniscus area (TMA) and total high-order aberrations (HOAs) for primary acquired nasolacrimal duct obstruction (PANDO).
METHODS: We retrospectively reviewed 56 eyes of 42 patients (7 men, 35 women; age, 72.7±13.1 years) who underwent EN-DCR or SG-BCI for PANDO in Toyama University Hospital from February 2020 to June 2022. In the EN-DCR and SG-BCI groups, we measured the patency of the lacrimal passage, preoperative and postoperative TMA, and HOAs of the central 4 mm of the cornea using optical coherence tomography (AS-OCT), six months postoperatively.
RESULTS: There was a positive correlation between preoperative TMA and preoperative HOAs in all cases. Postoperative patency of lacrimal passage was 100% in the EN-DCR and 80.8% in the SG-BCI group. There was a significant difference in the number of passages between the two groups (p = 0.01). Preoperative TMA and HOAs showed a significant postoperative decrease in both groups (EN-DCR group: p<0.01, p<0.01, SG-BCI group: p<0.01, p=0.03, respectively). We then calculated the rate of change of preoperative and postoperative TMA and HOAs and compared them between the two groups. The rate of change was significantly higher in the EN-DCR group than that in the SG-BCI group (TMA, p=0.03; HOAs, p=0.02).
CONCLUSIONS: Although both EN-DCR and SG-BCI are effective for PANDO, our results suggest that EN-DCR is more effective in improving TMA and HOAs.
METHODS: We retrospectively reviewed 56 eyes of 42 patients (7 men, 35 women; age, 72.7±13.1 years) who underwent EN-DCR or SG-BCI for PANDO in Toyama University Hospital from February 2020 to June 2022. In the EN-DCR and SG-BCI groups, we measured the patency of the lacrimal passage, preoperative and postoperative TMA, and HOAs of the central 4 mm of the cornea using optical coherence tomography (AS-OCT), six months postoperatively.
RESULTS: There was a positive correlation between preoperative TMA and preoperative HOAs in all cases. Postoperative patency of lacrimal passage was 100% in the EN-DCR and 80.8% in the SG-BCI group. There was a significant difference in the number of passages between the two groups (p = 0.01). Preoperative TMA and HOAs showed a significant postoperative decrease in both groups (EN-DCR group: p<0.01, p<0.01, SG-BCI group: p<0.01, p=0.03, respectively). We then calculated the rate of change of preoperative and postoperative TMA and HOAs and compared them between the two groups. The rate of change was significantly higher in the EN-DCR group than that in the SG-BCI group (TMA, p=0.03; HOAs, p=0.02).
CONCLUSIONS: Although both EN-DCR and SG-BCI are effective for PANDO, our results suggest that EN-DCR is more effective in improving TMA and HOAs.
摘要：
目的：通过评估原发性获得性鼻泪管阻塞（PANDO）的撕裂半月板面积（TMA）和总高阶像差（HOAs），比较经鼻鼻腔泪囊鼻腔吻合术（EN-DCR）与鞘管引导下泪镜探查和双管插管（SG-BCI）。
方法：我们回顾性分析了42例患者的56只眼（7例男性，35名妇女；年龄，72.7±13.1年），于2020年2月至2022年6月在富山大学医院为PANDO接受EN-DCR或SG-BCI。在EN-DCR和SG-BCI组中，我们测量了泪道的通畅度，术前和术后TMA，使用光学相干断层扫描（AS-OCT）和角膜中央4mm的HOA，术后六个月。
结果：所有病例术前TMA与术前HOA呈正相关。EN-DCR组术后泪道通畅率为100％，SG-BCI组为80.8％。两组之间的传代次数存在显着差异（p=0.01）。术前TMA和HOAs均显示两组术后明显下降(EN-DCR组:p<0.01,p<0.01,SG-BCI组:p<0.01,p=0.03)。然后计算术前和术后TMA和HOAs的变化率，并比较两组之间的差异。EN-DCR组的变更率明显高于SG-BCI组(TMA,p=0.03；HOAs，p=0.02)。
结论：尽管EN-DCR和SG-BCI对PANDO均有效，我们的结果表明EN-DCR在改善TMA和HOA方面更有效。
方法：我们回顾性分析了42例患者的56只眼（7例男性，35名妇女；年龄，72.7±13.1年），于2020年2月至2022年6月在富山大学医院为PANDO接受EN-DCR或SG-BCI。在EN-DCR和SG-BCI组中，我们测量了泪道的通畅度，术前和术后TMA，使用光学相干断层扫描（AS-OCT）和角膜中央4mm的HOA，术后六个月。
结果：所有病例术前TMA与术前HOA呈正相关。EN-DCR组术后泪道通畅率为100％，SG-BCI组为80.8％。两组之间的传代次数存在显着差异（p=0.01）。术前TMA和HOAs均显示两组术后明显下降(EN-DCR组:p<0.01,p<0.01,SG-BCI组:p<0.01,p=0.03)。然后计算术前和术后TMA和HOAs的变化率，并比较两组之间的差异。EN-DCR组的变更率明显高于SG-BCI组(TMA,p=0.03；HOAs，p=0.02)。
结论：尽管EN-DCR和SG-BCI对PANDO均有效，我们的结果表明EN-DCR在改善TMA和HOA方面更有效。
