目的:比较治疗慢性原发性泪小管炎(PLC)的两种不同的手术技术与临床可检测的结石。
方法:纳入标准:收集表现出与眼部受累的原发性泪小管炎(PLC)诊断一致的症状的患者。Gomori-Grocott甲胺银测试用于结石染色。根据手术技术确定两组。A组包括使用宫颈刮匙进行泪点保留泪小管刮治的患者,而B组患者接受了一次剪断泪点成形术和外侧泪小管切开术。失败定义为在任何时间复发的初始症状(眼部和泪小管炎症伴化脓性分泌物和po子点)。使用Fisher精确检验通过比较分析结果。
结果:在1987年至2017年期间,96例确诊为PLC的连续患者(96例)接受了手术治疗。收集数据并基于上述手术技术进行划分(A组和B组)。A组:51例,平均随访时间22个月[1-224],平均年龄51.5[25-83],手术失败率19.6%。B组:45例患者,平均随访时间27个月[1-176],平均年龄68[17-87]岁,手术失败率4.4%。证明了统计学意义,p值为0.033,比值比(OR)为0.1936,标准差(SD)为95%置信区间[0.0195-0.9885]。
结论:带外泪小管切开术的一次剪断点成形术是一种简单的,快速有效的程序,可以在术中进行更好的解剖可视化,因此在统计学上优于使用查耳素刮匙进行泪点保留泪小管刮治。
OBJECTIVE: To compare two distinct surgical techniques in the management of chronic Primary Lacrimal Canaliculitis (PLC) with clinically detectable concretions.
METHODS: Inclusion criteria: Patients presenting with symptoms consistent with the diagnosis of primary lacrimal canaliculitis (PLC) with ocular involvement were gathered. Gomori-Grocott Methenamine Silver test was used for concretion staining. Two groups were identified based on the surgical technique. Group A consisted of patients who underwent a punctum sparing canalicular curettage using a chalazion curette, while the patients in Group B underwent one-snip punctoplasty with lateral canaliculotomy. Failure was defined as recurrence of the initial symptoms at any time (ocular and canalicular inflammation with purulent discharge and pouting punctum). The results were analyzed by comparisons using a Fisher\'s exact test.
RESULTS: Ninety-six consecutive patients (96) with a confirmed diagnosis of PLC underwent surgical treatment between 1987 and 2017. Data were collected and divided based on the surgical technique discussed above (Group A and B). Group A: 51 cases with a mean follow-up time of 22 months [1-224] presented with a mean age of 51.5 [25-83] and a surgical failure rate of 19.6%. Group B: 45 patients with a mean follow-up time of 27 months [1-176], a mean age of 68 [17-87] years and a surgical failure rate of 4.4%. Statistical significance was demonstrated, with a p-value of 0.033, odds ratio (OR) of 0.1936 and Standard Deviation (SD) at a 95% confidence interval of [0.0195-0.9885].
CONCLUSIONS: One-snip punctoplasty with lateral canaliculotomy is a simple, fast and effective procedure that allows better anatomical visualization intraoperatively and is thus shown to be statistically superior to punctum sparing canalicular curettage using a chalazion curette.