눈물길 협착이 없는 눈물흘림 환자에서 가쪽눈꺼풀판띠고정술과 실리콘관삽입술의 효과
Lateral Tarsal Strip Procedure and Silicone Tube Intubation on the Functional Nasolacrimal Duct Obstruction
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목적: 눈물길의 폐쇄가 없는 환자에서 가쪽눈꺼풀판띠고정술만을 시행한 경우와 실리콘관삽입술을 병행한 경우의 효과를 비교하고자하였다. 대상과 방법: 아래눈꺼풀늘어짐을 동반한 눈물흘림 환자 20명 27안에 가쪽눈꺼풀판띠고정술을 시행한 경우와 18명 29안에 가쪽눈꺼풀판띠고정술과 실리콘관삽입술을 병용한 경우의 증상, 눈물띠 높이의 변화, 수술 효과를 비교하였다. 결과: 가쪽눈꺼풀판띠고정술군과 가쪽눈꺼풀판띠고정술 및 실리콘관삽입술 병용수술군의 평균 연령은 각각 60.3세, 64.8세, 술 전 눈물띠 높이는 각각 0.62 ± 0.23 mm, 0.62 ± 0.19 mm, 술 후는 0.43 ± 0.20 mm, 0.26 ± 0.10 mm였다. 술 후 눈물흘림 증상은 가쪽눈꺼풀판띠고정술군에서 74.1%, 병합수술군에서 86.2%의 호전을 보였다. 가쪽눈꺼풀판띠고정술의 방법으로 외안각보존법과 외안각절개술과 증상의 변화는 연관성이 없었다. 결론: 눈물길협착이 없는 눈물흘림 환자에서 가쪽눈꺼풀판띠고정술 및 실리콘관삽입술 병용수술 방법은 효과적으로 눈물흘림을 치료할 수 있을 것으로 사료된다. 눈물길세척술 및 눈꺼풀늘어짐검사를 통해 수술 방법의 선택 결정에 도움이 될 것으로 생각된다.
Abstract
Purpose: To compare the effects of the lateral tarsal strip procedure alone and the lateral tarsal strip procedure combined with silicone tube intubation in the treatment of functional lacrimal duct obstruction. Methods: The present study investigated 27 eyes of 20 patients underwent lateral tarsal strip procedure (LTS) alone and 29 eyes of 18 patients underwent combined lateral tarsal strip procedure and silicone tube intubation and who were diagnosed with functional lacrimal duct obstruction. The authors retrospectively reviewed patients’ medical records for information including age, gender, history, follow‐up period, tear meniscus height (TMH), and symptoms. Results: The average age of the LTS alone group was 60.3 years, and that of the combined groups was 65.9 years. The TMHs in the LTS only and combined operation groups were 0.62 ± 0.23 mm and 0.62 ± 0.19 mm before the operation and 0.43 ± 0.20 mm and 0.26 ± 0.09 mm after the operation, respectively. The postoperative improvement in epiphora was 74.1% after the LTS alone and 86.2% after combined LTS with silicone tube intubation. The postoperative improvement in epiphora and the operative technique of the lateral tarsal strip‐canthus sparing or cantholysis were not relevant. Conclusions: Lateral tarsal strip combined with silicone tube intubation appeared useful in the treatment of epiphora patients without anatomic lacrimal duct obstruction. Determining which operative technique of lateral tarsal strip procedure should be chosen is difficult, and the preoperative syringing and snap back test may be helpful.
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