공통눈물소관이 좁아진 눈물흘림 환자에서 실리콘관 삽입술의 장기 효과
Long-Term Results of Silicone Tube Intubation in Patients withCommon Canalicular Stenosis
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목적: 공통눈물소관이 좁아진 눈물흘림 환자에서 실리콘관 삽입술의 효과를 알아보고자 하였다. 대상과 방법: 2007년 8월에서 2010년 8월까지 눈물소관이상으로 실리콘관 삽입술을 시행 받은 후 12개월 이상 경과 관찰한 환자 107명 169안을 대상으로 의무기록을 후향적으로 연구하였다. 환자를 눈물소관 협착(A), 공통눈물소관 협착(B), 코눈물관 협착(C)으로 나누고, 수술 후 증상의 호전을 보이며 관류검사에서 눈물이 잘 통과되고 최종경과 관찰시점까지 호전이 유지되면 성공, 수술 후에도 증상호전을 보이지 않으면 실패, 실리콘관 제거 후 눈물흘림 증세가 나타나면 재발로 정의하였다. 결과: 평균경과관찰기간은 30.5개월이었으며, 성공률은 A군 66.0%, B군 75.4%, C군 56.3%로 B군에서 제일 높았으며, 눈물소관눈물주머니코안연결술을 이용한 다른 연구의 수술성공률과 비슷한 결과를 보였다. 결론: 공통눈물소관이 좁아진 환자에서 실리콘관삽입술은 술기가 비교적 간단하면서도 장기적으로 효과가 좋은 치료법의 하나라고생각한다.
Abstract
Purpose: To evaluate the clinical effects of silicone tube intubation in patients with epiphora and a narrow common canaliculus. Methods: We conducted a retrospective chart review of 107 patients (169 eyes) who underwent silicone tube intubation for treatment of canaliculus between August 2008 and August 2010 and who were followed for more than 12 months. The patients were divided into 3 groups: patients with canalicular stenosis (A), patients with common canalicular stenosis (B), and patients with nasolacrimal duct stenosis (C). Successful treatment was defined as attainment of the predefined requisites,which included improvements in the clinical symptoms following surgery, an adequate passage of tears resulting from post-operative probing and syringing, and continued improvement to the time of the patients’ final follow-up visit. In contrast,surgical failure was defined as the lack of post-operative symptom improvement, and recurrence was defined as the appearance of epiphora following the silicone tube extubation. Results: The average follow-up duration for the entire group of patients was 30.5 months. The success rates of Group A,Group B, and Group C were 66%, 75.4%, and 56.3%, respectively, demonstrating that Group B attained the highest success rate. These success rates are similar to rates resulting from other types of surgery such as canaliculodacryocystorhinostomy. Conclusions: Silicone tube intubation can be considered a relatively simple and effective surgical technology for the long-term treatment of patients with a narrow common canaliculus.
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