激光联合泪点塞在泪小点狭窄或阻塞疾病中的应用  

Application of laser and lacrimal implants for treatment of stenosis and obliteration of lacrimal punctum

作　　者：于静[1] 高明宏[1] 年春志[1] 肖卉[1] 

机构地区：[1]沈阳军区总医院眼科,辽宁省沈阳市110016

出　　处：《眼科新进展》2008年第5期379-380,383,共3页Recent Advances in Ophthalmology

摘　　要：目的通过观察泪小点狭窄或阻塞病例行Nd:YAG激光泪点成形术联合可降解泪点塞植入的治疗效果,评价联合方法对泪小点狭窄或阻塞的疗效。方法对24例(28眼)伴有溢泪症状的泪小点狭窄或阻塞的患者进行泪点扩张及激光泪点成形术后,将可降解胶原泪点塞植入泪小点内,术后连续2d复诊,观察泪点塞及角膜情况,15d后再次复查并行泪道冲洗,随访1～2个月。结果术中及术后无明显并发症,术后随访1～2个月,22眼全部1次治愈,术后无复发,1次治愈率为79%.其中泪小点开口狭窄的13眼全部治愈;好转4眼,均为60岁以上老年患者;无效1例(2眼),术后2个月复查,泪小点再次膜闭。结论Nd:YAG激光泪点成形术后植入胶原泪点塞治疗泪小点狭窄或阻塞是一种安全有效的新方法,患者痛苦小,易于接受。Objective To evaluate the clinical effectivity of Nd-YAG laser punctoplasty combined with soluble collagen implants for treatment of punctual stenosis and obliteration. Methods Punctum dilation and laser punctoplasty followed by soluble collagen implants inserted into lacrimal punctum were carried out on 24 cases （28 eyes） of punctual stenosis and obliteration with epiphora. Lacrimal implants and cornea were observed for two days postoperatively. The rinsing of lacrimal duct was undertaken fifteen days after postoperatively. All cases were followed up for one to two months. Results The diseases in 22 eyes were cured by the first-time treatment without any complications and recurrence. The success rate of the first-time treatment was 79%. Thirteen eyes of the punctual stenoses successfully recovered, and four eyes（ 14% ） became better with the decreased epiphora, the re-opening of lacrimal punctum, and lacrimal duct. Failure of the treatment was found in 2 eyes （7%） whose lacrimal punctum obliterated again at two months after surgery. Conclusion Nd-YAG laser punctoplasty combined with soluble collagen implants,which are less painful and receivable, are effective treatment for the punctual stenosis and obliteration.

关 键 词：泪小点狭窄 ND:YAG激光 泪点塞 

分 类 号：R777.2[医药卫生—眼科]