Retrograde circular intubation for the failed passage of a pigtail lacrimal probe in the management of non-specific inflammatory punctum occlusion.

IF 0.9 Q4 OPHTHALMOLOGY
Hesham A Ibrahim, Heba Nabil Sabry
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引用次数: 0

Abstract

Purpose: to describe the role of Retrograde Circular Intubation (RCI) technique in the management of non-specific inflammatory punctum occlusion (NIPO).

Methods: patients with NIPO who failed conservative treatment underwent 3-snip mini rectangular punctoplasty with adjunctive use of circular canalicular intubation. When the use of the pigtail lacrimal probe was not safely possible, circular intubation was accomplished by the RCI technique. A loop of 6/0 polypropylene suture was introduced into the upper lacrimal drainage system in a retrograde manner from the nose by pulling its two ends up from the puncta with 2/0 polypropylene sutures. The latter were placed between the punctum and the nose by a canulated probe or a Ritleng lacrimal probe (https://youtu.be/n31NKdWIUJM).

Results: Thirty-two patients (64 eyes) underwent circular intubation as an adjunct to the 3-snip mini rectangular punctoplasty. In 9 eyes (14%) the pigtail lacrimal probe couldn't pass safely across the upper lacrimal drainage system. Circular tube insertion was still possible with the RCI technique. Circular tubes were removed after two months. Over two years of follow-up, 27 patients (84%) maintained a patent punctum.

Conclusion: NIPO not responding to conservative measures can be managed surgically under an umbrella of medications. Circular canalicular intubation with its excellent stability and low morbidity is a valuable adjunctive to the 3-snip mini rectangular punctoplasty. When the passage of the pigtail lacrimal probe fails, circular tubes can be inserted with the RCI technique.

非特异性炎症性泪点阻塞的治疗中,尾状泪道探头通过失败的逆行环形插管。
目的:探讨逆行环形插管(RCI)技术在治疗非特异性炎性针孔闭塞(NIPO)中的作用。方法:保守治疗失败的NIPO患者行3- clip微型矩形点状成形术,辅助使用环管插管。当使用辫状泪管探头不安全时,采用RCI技术完成循环插管。将一圈6/0聚丙烯缝线从鼻腔逆行引入上泪引流系统,用2/0聚丙烯缝线将其两端从泪点向上拉。后者通过管状探针或Ritleng泪道探针(https://youtu.be/n31NKdWIUJM)放置在点状点和鼻子之间。结果:32例(64眼)行环形插管辅助3-剪小矩形点状成形术。9眼(14%)尾状泪探头不能安全通过上泪引流系统。RCI技术仍然可以插入圆管。两个月后取出圆形管。在两年的随访中,27例患者(84%)保持了针孔未闭。结论:保守治疗无效的NIPO可以在药物的保护下进行手术治疗。圆管插管稳定性好,发病率低,是一种有价值的辅助方法,可用于3- clip微型矩形点状成形术。当尾状泪探头通过失败时,可采用RCI技术插入圆形管。
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来源期刊
CiteScore
2.40
自引率
9.10%
发文量
136
期刊介绍: Orbit is the international medium covering developments and results from the variety of medical disciplines that overlap and converge in the field of orbital disorders: ophthalmology, otolaryngology, reconstructive and maxillofacial surgery, medicine and endocrinology, radiology, radiotherapy and oncology, neurology, neuroophthalmology and neurosurgery, pathology and immunology, haematology.
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