Résumé
·AIM:To investigate the clinical effect of high-frequency electric lacrimal duct plasty and annular lacrimal drainage tube implantation combined with acupuncture on upper lacrimal duct obstruction. ·METHODS:A total of 86 patients (102 eyes) with upper lacrimal duct obstruction who were treated in our department from July 2013 to June 2016 were 26 males(28 eyes) and 60 females(74 eyes). The treatment was high-frequency electric lacrimal duct plasty and annular lacrimal drainage tube implantation, combined with traditional Chinese medicine acupuncture plus oral medicine made by our department for 30d, followed up for 6mo after surgery to observe the effect. ·RESULTS:A total of 86 eyes(84.3%) were cured in 102 eyes,12 eyes (11.8%) were improved, 4 eyes (3.9%) were ineffective,and the total effective rate was 96.1%. Intraoperative complications: 1)orbital hemorrhage in 2 eyes, maybe caused by vessel injury at the front of ethmoidal sinus, the blood was stopped after press, the operation went successfully after 5d; 2) lacrimal duct rupture in 3 eyes, all because of uncareful operation or weak compliance;3)the duct was hard to implanted in 3 eyes and iatrogenic sinus occurred, we suggested them went to superior hospital. Postoperative complications:1) lacrimal duct rupture without epiphora in 3 eyes(2.9%);2)the duct draw out in 5 eyes (3.9%), the duct was draw and fixed to nasal vestibule, in other 4 eyes (4.9%) with fully draw out,in one of the 4,the duct was replaced and in the rest 3 of the 4, no treatment; 3) irritation symptoms at inner canthus in 11 eyes (10.8%) with symptomatic treatment; 4 ) granulation tissue hyperplasia in 2 eyes (2.0%), one of them near the lacrimal punctum was cut and disappeared after tobramycin dexamethasone eye drops,one in the lacrimal ductile, the duct was draw and after tobramycin dexamethasone eye drops or compound neomycin sulfate eye drops the hyperplasia did not enlarge, but the lacrimal passage irrigation was failed. ·CONCLUSION:It is effective of high-frequency electric lacrimal duct plasty and annular lacrimal drainage tube implantation combined with acupuncture on upper lacrimal duct obstruction.