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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front Med Chin    2009, Vol. 3 Issue (1) : 113-117     DOI: 10.1007/s11684-009-0001-1
RESEARCH ARTICLE |
Diagnosis and therapy of lacrimal system diseases by micro lacrimal endoscope
Nan XIANG1, Weikun HU1(), Jing YUAN2, Guigang LI1, Haixia LIU1
1. Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; 2. Department of Ophthalmology, Wuhan No. 6 Hospital, Jiang Han University, Wuhan 430015, China
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Abstract  

The lacrimal endoscope is applied to the diagnosis and therapy of the disorders of the lacrimal system in combination with laser or micro drills under orthophoria. The changes of mucous membranes, the characteristics of pathological changes and the predilection sites of lacrimal system diseases were initially approached. One hundred and forty six pairs of eyes of 128 patients with lacrimal system disease were observed by the lacrimal endoscope in the Ophthalmology Department of Tongji Hospital from June 2006 to March 2007. The dynamic changes in mucous membranes, lesion sites, secreted substances and formation of membrane could be observed under orthophoria. Combined with laser or micro drill, the endoscope was applied to the therapy of lacrimal system disorders and the difference before and after the treatment was observed. Results are as follows: (1) The examination and therapy using the lacrimal endoscope were completed under topical anesthesia in 122 patients, and 6 patients of neonatorum dacryocystitis were examined and treated under general anaesthesia. All patients reported painless. (2) Sharp images of the lacrimal system were obtained by the endoscope. Normal lacrimal mucosal membrane was smooth and light pink, expanded and unobstructed during irrigation. In chronic dacryocystitis patients, the inhomogeneous colour of mucosal membranes was red and white, with different degrees of fibrotic membranes at the superior, middle and inferior parts of the nasolacrimal canals and secreted substances at sac could be observed. The lacrimal ducts could not be expanded and obstructed during irrigation. The patients with lacrimal system obstruction had different extents of membrane formation, and stenosis or complete obstruction of the lacrimal duct could be observed, and the corresponding mucosal membrane was not smooth which could not be expanded and obstructed during irrigation. (3) After the treatment by the endoscope combined with laser or micro drill, the major proliferation of the membrane disappeared and the lacrimal duct was unobstructed during irrigation. The cure rate and effective rate were 80.1% and 93.1%, respectively. The lacrimal endoscope is a new method in the diagnosis of lacrimal system diseases. Through a combination with laser or micro drill to carry out the therapy under orthophoria, it will bring a great change to the diagnosis and therapy of lacrimal system diseases.

Keywords lacrimal apparatus diseases      endoscopes     
Corresponding Authors: HU Weikun,Email:huweikun1@163.com   
Issue Date: 05 March 2009
URL:  
http://academic.hep.com.cn/fmd/EN/10.1007/s11684-009-0001-1     OR     http://academic.hep.com.cn/fmd/EN/Y2009/V3/I1/113
Fig.1  Normal and abnormal mucosa membrane image of lacrimal system in lacrimal endoscope. (a) normal canalis nasolacrimalis; (b) membrane obstruction in canalis nasolacrimalis; (c) normal canaliculus; (d) membrane obstruction in canaliculus; (e) congestion in dacryocyst; (f) secretion in dacryocyst.
Fig.2  Image of canalis nasolacrimalis obstruction before and after laser plasty in lacrimal endoscope. (a) membrane obstruction in canalis nasolacrimalis; (b) canalis nasolacrimalis after lacrimal system plasty with laser.
obstruction sitecure rateimprovement rateeffective rateinvalid rate
before lacrimal sac (n = 33)18 (54.5)8 (24.2)26 (78.7)7 (21.3)
after lacrimal sac (n = 113)99 (87.6)11 (9.7)110 (97.3)3 (2.7)
total (n = 146)117 (80.1)19(13.0)136 (93.1)10 (6.9)
Tab.1  Effect analysis in patients with lacrimal passage obstruction six months (or more) after therapy
, %
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