Effect and influencing factors of Nd:YAG laser dacryocystoplasty combined with lacrimal stent implantation in the treatment of lacrimal duct obstruction

• Main Authors: Si-Min Tan, De-Mao Liang
• Format: Article
• Language: English
• Published: Press of International Journal of Ophthalmology (IJO PRESS) 2020-11-01
• Series: Guoji Yanke Zazhi
• Subjects: lacrimal duct obstruction; laser lacrimal duct angioplasty; lacrimal duct stent; influencing factors; flushing frequency; bony lacrimal duct
• Online Access: http://ies.ijo.cn/cn_publish/2020/11/202011031.pdf

AIM: To analyse the curative effect and influencing factors of Nd:YAG laser lacrimal duct angioplasty combined with lacrimal duct stent implantation on the treatment of lacrimal duct obstruction. <p>METHODS: Totally 150 eyes of 150 patients with lacrimal duct obstruction admitted to our hospital from June 2017 to June 2019 were selected and treated with Nd:YAG laser lacrimal duct plasty combined with lacrimal duct stent placement. Follow-up 6mo after extubation, the patients were divided into effective group(135 cases, 135 eyes)and ineffective group(15 cases, 15 eyes)according to the clinical efficacy. General information, complications, causes of lacrimal duct blockage, postoperative lacrimal duct flushing frequency and clinical data such as the condition of bony lacrimal duct, analysis of related factors affecting the therapeutic effect.<p>RESULTS: Follow-up 6mo after extubation, the effective rate and recurrence rate were 90.0%(135 eyes)and 1.3%(2 eyes)respectively. The course of the disease in the effective group was significantly shorter than that of the ineffective group, and the incidence of complications was significantly lower than in the ineffective group, the length of osseous lacrimal duct obstruction was significantly shorter than that of the ineffective group, the minimum diameter of the obstruction was significantly longer than that of the ineffective group, there was a significant difference in the frequency of tract flushing(all <i>P</i><0.05). Logistic regression analysis showed that the course of disease(<i>OR</i>=4.600; 95%<i>CI</i>: 3.448-6.136), complications(<i>OR=</i>2.524; 95% <i>CI</i>: 1.481-4.302),the length of osseous lacrimal duct obstruction(<i>OR</i>=3.785; 95% <i>CI</i>: 1.844-7.770)and the minimum diameter of the obstruction(<i>OR</i>=2.330; 95% <i>CI </i>1.464-3.708), as well as flushing frequency(<i>OR</i>=4.773; 95% <i>CI</i>: 2.227-10.231)were related factors affecting the therapeutic effect of Nd:YAG laser lacrimal duct plasty combined with lacrimal duct stent implantation.<p>CONCLUSION: Nd:YAG laser lacrimal duct angioplasty combined with lacrimal duct stent implantation is effective in the treatment of lacrimal duct obstruction, with the lower incidence of complications and recurrence rate. The course of disease, complications, postoperative lacrimal passage irrigation frequency and the condition of bone lacrimal passage are all influencing factors, among which the effective rate can be improved by properly increasing the number of lacrimal duct expansion irrigation.