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1.
Vestn Oftalmol ; 137(1): 13-20, 2021.
Artigo em Inglês, Russo | MEDLINE | ID: mdl-33610144

RESUMO

Despite the success of dacryocystorhinostomy (DCR) in the treatment of lacrimal drainage system (LDS) obliteration and the use of medical and surgical methods to prevent its recurrence, the number of relapses reaches 37%. The main etiological factor leading to this pathology is partial (stenosis) or complete obstruction of the ostium. PURPOSE: To study the effectiveness of endonasal balloon dacryoplasty in partial or complete obstruction of dacryocystorhinostomy ostium. MATERIAL AND METHODS: The study involved 122 patients (127 cases) with relapse after endonasal endoscopic dacryocystorhinostomy performed 6 months to 3 years ago to treat partial or complete obstruction of lacrimal sac neck. Patients of the 1st group (41 cases) underwent endonasal balloon dacryoplasty, patients of the 2nd group (42 cases) underwent endonasal balloon dacryoplasty with bicanalicular silicone stenting, patients of the 3rd group (44 cases) underwent revision endonasal endoscopic dacryocystorhinostomy with bicanalicular silicone stenting. RESULTS: After 12 months follow-up, positive results were observed in 85.7% of cases with ostium stenosis and 80.0% of cases with complete obstruction of the ostium among group 1 patients; in 86.4% of cases with ostium stenosis and 85.0% of cases with complete obstruction of the ostium among group 2 patients; and in 81.0% of cases with ostium stenosis and 82.6% of cases with complete obstruction of the ostium among group 3 patients. CONCLUSION: The obtained results give grounds to recommend inclusion of endonasal balloon dacryoplasty in the standards of treatment for patients with partial (stenosis) and complete obliteration of dacryocystorhinostomy ostium.


Assuntos
Dacriocistorinostomia , Aparelho Lacrimal , Obstrução dos Ductos Lacrimais , Ducto Nasolacrimal , Endoscopia , Humanos , Obstrução dos Ductos Lacrimais/diagnóstico , Obstrução dos Ductos Lacrimais/etiologia , Obstrução dos Ductos Lacrimais/terapia , Ducto Nasolacrimal/cirurgia , Stents , Resultado do Tratamento
2.
Vestn Oftalmol ; 136(5. Vyp. 2): 163-169, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33063959

RESUMO

PURPOSE: To compare the effectiveness of minimally invasive techniques used for the treatment of common canalicular (CC) ostium stenosis (or obliteration) in post-dacryocystorhinostomy (post-DCR) patients. MATERIAL AND METHODS: The study included 121 patients (127 cases), of which 61 patients (64 cases) had stenosis of the CC ostium and 60 patients (63 cases) had CC ostium obliteration. All stenoses and obliterations were recurrent and developed 6 months to 5 years after primary endonasal endoscopic DCR. Patients were divided into 3 groups. Group 1 included 20 patients (20 cases) with stenosis and 21 patients (22 cases) with CC ostium obliteration who underwent transcanalicular balloon dacryoplasty (DCP), group 2 - 20 patients (21 cases) with stenosis and 20 patients (21 cases) with CC ostium obliteration who underwent transcanalicular DCP and bicanalicular intubation, and group 3 - 21 patients (23 cases) with stenosis and 19 patients (20 cases) with CC ostium obliteration who received bicanalicular intubation alone. Results were evaluated 12 months after the intervention. RESULTS: The treatment was effective in as many as 80% and 68.2% of cases (respectively) in group 1, 76.2% and 66.7% of cases (respectively) in group 2, and 56.5% and 50% of cases (respectively) in group 3. CONCLUSION: The study proves transcanalicular DCP effective alone and shows no need in potentially complicated lacrimal ducts intubation.


Assuntos
Dacriocistorinostomia , Aparelho Lacrimal , Obstrução dos Ductos Lacrimais , Ducto Nasolacrimal , Constrição Patológica , Humanos , Obstrução dos Ductos Lacrimais/diagnóstico , Obstrução dos Ductos Lacrimais/etiologia , Obstrução dos Ductos Lacrimais/terapia , Ducto Nasolacrimal/cirurgia , Resultado do Tratamento
3.
Vestn Oftalmol ; 136(6): 65-69, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33084281

RESUMO

The problem of reconstruction of the lacrimal drainage system in cases of obliteration of both lacrimal points and/or both lacrimal canaliculi remains one of the most difficult in dacryology. The most common and effective operation for this pathology is Conjunctival dacryocystorhinostomy using tubes developed by L. Jones in 1962. However, wearing the tube for a long time and the complications associated with it can cause dissatisfaction with the treatment, even if the surgery was successful. The surgery technique and the tubes design have undergone numerous modifications to increase the amount of positive outcomes and reduce the number of complications. The results of original studies on this problem were analyzed revealing a lack of knowledge about the optimal design and material of the implant. There are few studies aimed at developing methods that ensure persistent preservation of the anastomosis after tube removal.


Assuntos
Dacriocistorinostomia , Aparelho Lacrimal , Túnica Conjuntiva/cirurgia , Aparelho Lacrimal/cirurgia
4.
Vestn Oftalmol ; 136(6): 78-83, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33084283

RESUMO

Studying the pathogenesis of concrements formation in lacrimal ducts is of fundamental and practical importance. This article attempts to analyze available information related to the pathogenesis of this phenomenon, provides information on the etiopathogenesis, physical and chemical properties of concrements obtained from horizontal and vertical parts of the lacrimal duct, and considers in detail bacteriological and mycotic composition of concrements, as well as various theories of their formation. The analysis helped justify the need to separate the concrements formed in the horizontal and vertical parts of the lacrimal ducts on the basis of differences in their pathogenesis. Actinomycotic infection is the cause of concrements formation in the horizontal part of the lacrimal duct in the overwhelming majority of cases. The process of concrements formation in the vertical part of the lacrimal duct in some cases occurs as a result of previous clinical events, but in many other cases the trigger mechanisms remain unknown. To date, the role of the initial narrowing of the lacrimal ducts in the pathogenesis of concrements is not clearly defined. The accumulated knowledge regarding the pathogenesis of concrements is currently not enough to formulate a complete theory of the development of this phenomenon. Further studies of the pathogenesis of concrements will help develop new diagnostic and therapeutic measures aimed at restoring the patency of the lacrimal ducts.


Assuntos
Aparelho Lacrimal , Pálpebras , Aparelho Lacrimal/diagnóstico por imagem
5.
Vestn Oftalmol ; 135(5. Vyp. 2): 199-203, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31691660

RESUMO

At present, installation of punctal plugs (tear duct occluders) draws attention of ophthalmologists, but this method of treating dry eye syndrome (DES) is not without complications. Considering the rise of DES occurrence - the tendency anticipated to continue - as well as expansion of indications for installation of tear duct occluders, their usage can be expected to rise. The article describes a relatively rare clinical case that involved intracanalicular migration of silicone punctal plug. A female patient of 36 years old sought medical help in Research Institute of Eye Diseases (Moscow) to treat a lump in the area of lower lacrimal punctum in the left eye that was growing in size; the lump had appeared around 2 months prior to the visit. Patient's medical history read that around 2 years ago she had a silicone occluder installed in the lower lacrimal punctum of the left eye. On examination, in the area of lower lacrimal punctum, a body with a nutrient vascular pedicle deriving from lower lacrimal duct could be found. The occluder was absent in the opening of the lacrimal punctum. A revision of lower tear duct cavity was performed to remove its contents. The body filling tear duct opening was removed with forceps. Substance was then sent for histological examination. Tear duct was scraped out, the silicone occluder removed and sent to laboratory for scanning electron microscopy. The patient had no complaints 6 months after the procedure. CONCLUSION: The study showed that the forming body was granuloma resulting from aseptic inflammation. Surface of the silicone occluder in retention of lacrimal pathways remained unchanged. Described surgical tactic is suitable for treating patients with intracanalicular punctal plug migration.


Assuntos
Granuloma , Aparelho Lacrimal , Plug Lacrimal , Adulto , Síndromes do Olho Seco , Feminino , Granuloma/etiologia , Humanos , Implantação de Prótese , Plug Lacrimal/efeitos adversos , Elastômeros de Silicone
6.
Vestn Oftalmol ; 135(4): 19-26, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31573553

RESUMO

INTRODUCTION: Fibrosis is the most important pathologic condition involved in undesirable outcomes of dacryocystorhinostomy. A number of biochemical factors are currently known to have an effect on wound healing by promoting excessive scarring. Isoforms of transforming growth factor ß (TGF-ß1) are considered the 'main' pro-fibrotic factor, but wound healing is also affected by other cytokines such as connective tissue growth factor (CTGF), which stimulates fibrosis, and fibroblast growth factor (FGF-2), which acts as antagonist to it. PURPOSE: To investigate correlations between endoscopic endonasal dacryocystorhinostomy outcomes and certain mediators of fibrosis. MATERIAL AND METHODS: The study included 45 cases of endoscopic endonasal dacryocystorhinostomy. The patients were grouped according to surgery outcome: patients with unsuccessful surgical treatment were assigned to group 1 (n=10); patients with successful surgical treatment - to group 2 (n=34). One patient was excluded from the study. Full-layer biopsy specimen were taken from patients' nasal mucosa before the surgery. TGF-ß1, TGF-ß2, TGF-ß3, CTGF, FGF-2 concentrations were evaluated using ELISA and normalized by total protein concentration. RESULTS: Surgical failure was observed in 10 cases (22.72%). CTGF concentration was significantly correlated with negative outcome (p<0.05) and was elevated in most specimen obtained from group 1. No significant correlation was noted between the concentrations of other evaluated cytokines in nasal mucosa specimens and the surgical outcome. CONCLUSION: The study found a correlation between CTGF concentration in nasal mucosa and dacryocystorhinostomy outcome, which supports the hypothesis suggested by several authors linking dacryocystorhinostomy failure with chronic inflammation in nasal mucosa.


Assuntos
Dacriocistorinostomia , Citocinas , Fibrose , Humanos , Inflamação , Fator de Crescimento Transformador beta
7.
Vestn Oftalmol ; 134(5. Vyp. 2): 270-275, 2018.
Artigo em Russo | MEDLINE | ID: mdl-30499528

RESUMO

The article reviews the literature devoted to modern intraoperative methods of preventing cicatricial process at the site of dacryostoma after endonasal endoscopic dacryocystorhinostomy. Despite the constant improvement of the surgery technique, complications in the postoperative period still occur. They include the formation of granulation tissue at the sites of dacryostoma, synechiae in the nasal cavity, or narrowing of the dacryostoma, which ultimately leads to a relapse of the disease. The main prevention methods are construction of flaps from the medial wall of the lacrimal sac, from mucosa of the nasal cavity, and intubation of the dacryostoma with the lacrimal implant. They are used separately and in various combinations.


Assuntos
Dacriocistite , Dacriocistorinostomia , Ducto Nasolacrimal , Endoscopia , Humanos , Intubação , Recidiva
8.
Vestn Oftalmol ; 134(5. Vyp. 2): 276-281, 2018.
Artigo em Russo | MEDLINE | ID: mdl-30499529

RESUMO

The article reviews the literature on methods of evaluating the morphological and functional state of the eyelids in chronic blepharitis. Development of methods continues together with further research on the etiology and pathogenesis of the disease.


Assuntos
Blefarite , Doença Crônica , Pálpebras , Humanos
9.
Vestn Oftalmol ; 133(5): 16-23, 2017.
Artigo em Russo | MEDLINE | ID: mdl-29165408

RESUMO

Mitomycin-C (MMC) is the most frequently used agent for prevention of excessive scarring at the osteotomy site after endoscopic endonasal dacryocystorhinostomy (EEDCR), which, however, being applied during the final stage of the surgery, shows questionable effectiveness. AIM: to evaluate the effectiveness of a new administration route of mitomycin C in EEDCR. MATERIAL AND METHODS: The study included 86 patients (95 cases) in the age range of 62.3±9 years with primary acquired nasolacrimal duct obstruction. All patients underwent P.J. Wormald modification of EEDCR and were further divided into 2 groups. In group 1, MMC was injected into the nasal cavity and lacrimal sac mucosa, while in group 2 it was applied locally according to the standard procedure. To measure tissue concentrations of MMC, mucosal biopsies were taken in patients of Group 1. Systemic absorption of MMC was studied through blood samples in both groups. Clinical efficacy was assessed in 14±5 months after surgery. RESULTS: immediately after injection, the average tissue concentration of mitomicyn C in patients of Group 1, was 390±10 µg/g and 30 minutes later - 120±20 µg/g. No mitomycin C was found in Day 1 tissue samples and in any of the blood samples. Positive clinical results were reported in 97.9% of cases from Group 1 and in 87.2% of cases from Group 2. CONCLUSION: The method of injecting MMC during the final stage of EEDCR has proved clinically effective and safe and can be recommended for use in clinical practice.


Assuntos
Cicatriz , Dacriocistorinostomia , Obstrução dos Ductos Lacrimais , Mitomicina/administração & dosagem , Complicações Pós-Operatórias/prevenção & controle , Idoso , Antibióticos Antineoplásicos/administração & dosagem , Cicatriz/etiologia , Cicatriz/prevenção & controle , Dacriocistorinostomia/efeitos adversos , Dacriocistorinostomia/métodos , Feminino , Humanos , Injeções/métodos , Obstrução dos Ductos Lacrimais/diagnóstico , Obstrução dos Ductos Lacrimais/terapia , Masculino , Pessoa de Meia-Idade , Ducto Nasolacrimal/patologia , Ducto Nasolacrimal/cirurgia , Cirurgia Endoscópica por Orifício Natural/efeitos adversos , Cirurgia Endoscópica por Orifício Natural/métodos , Resultado do Tratamento
10.
Vestn Oftalmol ; 133(4): 89-96, 2017.
Artigo em Russo | MEDLINE | ID: mdl-28980572

RESUMO

Scarring is one of the main causes of surgical failure in a number of eye diseases, dacryologic conditions in particular. The process of wound healing, including postoperative wound healing, goes through several stages mediated by various biochemical factors, such as growth factors and pro- and anti-inflammatory cytokines. The balance between the latter directly influences the wound healing. However, current data on the effect of these factors on postoperative outcomes are few and contradictory. Thus, in dacryology as well as in other areas of ophthalmology, the role of cytokines and growth factors in healing of surgical wounds is being intensively researched.


Assuntos
Cicatriz , Dacriocistorinostomia/efeitos adversos , Complicações Pós-Operatórias/metabolismo , Fator de Crescimento Transformador beta/metabolismo , Cicatrização/fisiologia , Cicatriz/etiologia , Cicatriz/metabolismo , Dacriocistorinostomia/métodos , Oftalmopatias/cirurgia , Humanos
11.
Vestn Oftalmol ; 132(3): 15-20, 2016.
Artigo em Russo | MEDLINE | ID: mdl-27456559

RESUMO

AIM: To develop surgical indications in dacryostenosis within the vertical portion of lacrimal pathways that would consider findings of single-photon emission computed tomography (SPECT) combined with X-ray computed tomography (CT). MATERIAL AND METHODS: A total of 96 patients with isolated vertical-portion dacryostenosis (127 cases) were enrolled. The examination included collecting Munk's scores for epiphora, optical coherence tomography of the lower tear meniscus, lacrimal scintigraphy, and SPECT/CT. Group 1 (40 cases) was composed of patients with lacrimal obstruction on CT, group 2 (87 cases) - of those whose lacrimal pathways proved passable. There were also 3 patients (4 cases) from group 1, whose lacrimal pathways, despite being blocked on CT, were still passable on SPECT. Surgeries performed in group 1 were endoscopic endonasal dacryocystorhinostomy (DCR) (36 cases) and pathways recanalization with bicanalicular intubation and balloon dacryoplasty (DCP) (4 cases). In group 2, all patients (87 cases) underwent recanalization with bicanalicular intubation (supplemented with balloon DCP in 32 cases). Surgical results were evaluated 8-12 months after the treatment. In group 2, particular attention was paid to the concordance in locations of dacryostenosis provided by CT and SPECT scans. RESULTS: Favorable outcomes of endoscopic endonasal DCR were obtained in as many as 32 cases from group 1 (88.9%), while in 4 cases (12.1%) the condition relapsed. Of those patients whose stenosis was not complete on SPECT, 3 cases (75.0%) improved, 1 (25.0%) - relapsed. In group 2, favorable outcomes were obtained in 65 cases (74.7%), relapses were 22 (25.3%). A high concordance in stenosis locations by CT and SPECT was noted in 60 cases of those who improved (92.3%) and 3 cases of those who relapsed (13.6%). CONCLUSION: The value of information provided by SPECT/CT has proved high in patients with nasolacrimal duct stenosis or obstruction. A combined scan allows to establish causal relationships between anatomical changes and functional failure of lacrimal pathways and to make an optimal treatment choice.


Assuntos
Dacriocistorinostomia , Endoscopia , Aparelho Lacrimal , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Dacriocistorinostomia/efeitos adversos , Dacriocistorinostomia/métodos , Endoscopia/efeitos adversos , Endoscopia/métodos , Feminino , Humanos , Aparelho Lacrimal/diagnóstico por imagem , Aparelho Lacrimal/cirurgia , Obstrução dos Ductos Lacrimais/diagnóstico , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Seleção de Pacientes , Prevenção Secundária
12.
Vestn Oftalmol ; 132(6): 101-107, 2016.
Artigo em Russo | MEDLINE | ID: mdl-28121306

RESUMO

Optical coherence tomography (OCT) based lacrimal meniscometry is currently the most accurate method used to determine dimensions of tear meniscus. According to related literature, the latter gets reliably reduced after treatment of nasolacrimal duct obstructions. However, the relationship between morphometric parameters of tear meniscus and the intensity of epiphora has not been established. Even an adequate study parameter has not been yet identified. AIM: To investigate the significance of OCT based lacrimal meniscometry in determining the extent of insufficiency of lacrimal drainage. MATERIAL AND METHODS: A total of 108 measurements of the lower tear meniscus were taken. Of them, 23 measurements were taken in healthy volunteers, who had no complaints of epiphora, 59 - in patients with epiphora of different intensity, and 26 - in patients after surgical intervention. Meniscometry was performed with RTVue-100-2 (Optovue, USA) optical coherence tomograph. The tear meniscus 'height', 'depth', and coefficient were evaluated. Munk's scores for epiphora were also collected. Spearman's correlation was applied to assess the morphometry results and Munk's scores. A separate analysis was performed for patients who were examined before and after dacryological treatment. Differences were evaluated with the Kruskal-Wallis H test. RESULTS: Statistically reliable differences were found between the meniscus 'height' and 'depth' values at different epiphora intensities (p<0.001 for both parameters; H=25.35 and 22.01, respectively), however, the meniscus coefficients showed no significant difference in these patients (p=0.8, H=1.57). Moreover, there was a highly reliable (p<0.001) medium strength direct correlation between the meniscus 'height' and 'depth' and the Munk's scores (R=0.46 and R=0,48, respectively), while the correlation between the meniscus coefficient and the Munk's scores appeared weak and lowly reliable (p=0.20, R=0.14). CONCLUSION: Lower meniscus morphometry with 'depth' measurement is a comprehensive method to assess the state of lacrimal drainage system. However, it should not be used alone due to significant variations in morphometric parameters, particularly in patients with intensive epiphora.


Assuntos
Doenças do Aparelho Lacrimal/diagnóstico , Aparelho Lacrimal/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
13.
Vestn Oftalmol ; 132(6): 87-92, 2016.
Artigo em Russo | MEDLINE | ID: mdl-28121304

RESUMO

Ostium closure due to local reparative processes is the most common cause of recurrence after endoscopic endonasal dacryocystorhinostomy (DCR), but as yet poorly studied. AIM: To perform morphological study of reparative processes at osteotomy site after endoscopic endonasal DCR. MATERIAL AND METHODS: The study included 18 patients (18 women) aged 62.59±10.07 years with nasolacrimal duct obstruction, who underwent endoscopic endonasal DCR (P.J. Wormald modification). Osteotomy site biopsies were taken on days 2, 5, 7, 10, 14, 21, 28, and 60 after the surgery. All the samples were stained with haematoxylin and eosin. For further details on cellular composition of inflammatory infiltrate, 54 samples were also processed into semi-thin sections. The slides were then viewed under Leica DM-2500 (Leica, Germany) photomicroscope. Leica DFC320 digital camera and ImageScope Color software were used for image acquisition and analysis. RESULTS: Morphological examination revealed the predominance of inflammatory cells in biopsy material on day 1 after DCR. On day 14, the number of cells would usually be reduced indicating the completion of the exudative phase of inflammation. Since then, activated fibroblasts prevailed over the rest of cellular elements. Twenty eight days after DCR, proliferating fibroblasts and collagen fibers were present. Sixty days after the surgery, fibrillar component prevailed over cells and showed compaction. CONCLUSION: Our results demonstrate that the reparation process nears completion before day 60 after the surgery. A series of morphological examinations of biopsy material from osteotomy sites has revealed individual features of reparation in nasal and lacrimal sac mucosa after endoscopic endonasal DCR.


Assuntos
Dacriocistorinostomia , Obstrução dos Ductos Lacrimais/patologia , Ducto Nasolacrimal , Idoso , Biópsia/métodos , Dacriocistorinostomia/efeitos adversos , Dacriocistorinostomia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ducto Nasolacrimal/diagnóstico por imagem , Ducto Nasolacrimal/patologia , Cirurgia Endoscópica por Orifício Natural/efeitos adversos , Cirurgia Endoscópica por Orifício Natural/métodos , Osteotomia/métodos , Recidiva
14.
Vestn Oftalmol ; 131(4): 66-73, 2015.
Artigo em Russo | MEDLINE | ID: mdl-26489122

RESUMO

AIM: to compare the effectiveness of balloon dacryoplasty (DCP) for stenoses at different levels of the vertical portion of lacrimal pathways and to establish the necessity of consequent intubation. MATERIAL AND METHODS: A total of 120 clinical cases in 85 patients (66 females and 19 males with the mean age of 53.61 ± 11.82 years) have been analyzed. Patients with cervical stenosis of the lacrimal sac constituted two groups: group 1 (19 patients, 30 balloon DCP surgeries) and group 2 (22 patients, 30 balloon DCP surgeries with Ritleng intubation). Two other groups consisted of patients with nasolacrimal orifice stenosis: group 3 (21 patients, 30 balloon DCP surgeries) and group 4 (23 patients, 30 balloon DCP surgeries with Ritleng intubation). Besides routine examinations, the assessment included collection of Munk's scores for epiphora, evaluation of health-related quality of life, lacrimal meniscometry, lacrimal scintigraphy, contrast enhanced multi-slice spiral computed tomography of lacrimal pathways, and single-photon emission computed tomography. The follow-up period was 6 months. RESULTS: In group 1 a complete recovery was achieved in 18 (60.00%) cases, improvement--in 9 (30.00%) cases, while a relapse occurred in 3 (3.00%) cases; in group 2, there were 18 (60.00%) recoveries, 10 (33.33%) improvements, and 2 (6.67%) relapses; in group 3--12 (40.00%) recoveries, 5 (16.66%) improvements, and 13 (43.34%) relapses; in group 4--19 (63.33%) recoveries, 8 (26.67%) improvements, and 3 (10.00%) relapses. CONCLUSION: Balloon dacryoplasty is effective in restoring patency of occluded lacrimal pathways. Success rate is higher in cervical stenoses of the lacrimal sac than in nasolacrimal orifice stenoses. Ritleng intubation after balloon DCP favors better outcomes in patients with nasolacrimal orifice stenosis.


Assuntos
Dacriocistorinostomia , Aparelho Lacrimal/patologia , Obstrução dos Ductos Lacrimais , Complicações Pós-Operatórias/diagnóstico , Qualidade de Vida , Adulto , Dacriocistorinostomia/efeitos adversos , Dacriocistorinostomia/métodos , Feminino , Humanos , Obstrução dos Ductos Lacrimais/diagnóstico , Obstrução dos Ductos Lacrimais/fisiopatologia , Obstrução dos Ductos Lacrimais/psicologia , Masculino , Pessoa de Meia-Idade , Cintilografia/métodos , Recidiva , Tomografia Computadorizada Espiral/métodos , Resultado do Tratamento
15.
Vestn Rentgenol Radiol ; (2): 23-7, 2015.
Artigo em Russo | MEDLINE | ID: mdl-26165003

RESUMO

OBJECTIVE: To study the diagnostic importance of a new Indis software package for the postprocessing of the results of radionuclude examinations (Center for Information and Diagnostic Systems, St. Petersburg, Russia) when analyzing the results of lacrimal scintigraphy. MATERIAL AND METHODS: Dynamic lacrimal scintigraphy was carried out in 6 volunteers (12 eyes) and 20 patients (32 years) with dacryostenosis. The examined Indis program and the known Syngo program (Siemens, Germany) were used to calculate the elimination half-life of a radiopharmaceutical from the interest region corresponding to the whole ocular surface. The time taken to postprocess the results of the examination was also determined. RESULTS: When calculations were made using the Indis program and the Syngo system, the elimination half-lives of a tracer in the volunteers was 6.57 ± 2.46 and 7.54 ± 3.21 min, respectively. These in the patents with dacryostenosis were 69.39 ± 65.52 and 74.85 ± 64.59 min. With these programs, the times taken for postprocessing were 12.3 ± 4.2 and 26.3 ± 7.9 min, respectively. CONCLUSION: The investigation showed the practical significance of the Indis software package in processing the data of lacrimal scintigraphy. The calculations made with the Indis program correspond to those made with the known Syngo program. The convenience and ergonomics of the program can precisely identify the region of interest. The economic justification of the system is associated with the shorter time taken to postprocess and interpret the results of lacrimal scintigraphy. The Indis software package may be recommended for use in the examination and treatment monitoring in patients with abnormal lacrimaton.


Assuntos
Processamento Eletrônico de Dados/métodos , Aparelho Lacrimal/diagnóstico por imagem , Obstrução dos Ductos Lacrimais/diagnóstico por imagem , Design de Software , Adulto , Idoso , Estudos Cross-Over , Feminino , Humanos , Aparelho Lacrimal/metabolismo , Obstrução dos Ductos Lacrimais/metabolismo , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Cintilografia , Compostos Radiofarmacêuticos/farmacocinética , Adulto Jovem
16.
Vestn Oftalmol ; 131(2): 99-104, 2015.
Artigo em Russo | MEDLINE | ID: mdl-26080591

RESUMO

AIM: To develop the optimal protocol for balloon dacryoplasty (DCP) through an experiment. MATERIAL AND METHODS: The experiment enrolled 12 Chinchilla rabbits (24 eyes). DCP protocol for group 1 (5 rabbits, 10 eyes) implied two dilations of 90 and 60 sec followed by another two of the same duration, while in group 2 (5 rabbits, 10 eyes) all four dilations were of 90 sec. The balloon was moved proximally before the every third dilation. The remaining 2 rabbits (4 eyes) who did not receive balloon DCP constituted the control group. The animals were killed on days 1, 3, 7, and 14. In all cases nasolacrimal duct morphology was studied. RESULTS: By day 14 after the procedure, inflammatory changes in nasolacrimal ducts either had resolved (protocol 1) or persisted (protocol 2).


Assuntos
Dacriocistorinostomia , Ducto Nasolacrimal , Complicações Pós-Operatórias/patologia , Animais , Dacriocistorinostomia/instrumentação , Dacriocistorinostomia/métodos , Ducto Nasolacrimal/patologia , Ducto Nasolacrimal/cirurgia , Duração da Cirurgia , Coelhos , Resultado do Tratamento
17.
Vestn Oftalmol ; 131(5): 68-73, 2015.
Artigo em Russo | MEDLINE | ID: mdl-26845875

RESUMO

Success rate of endonasal dacryocystorhinostomy (DCR) varies from 82% to 91%. The bulk of unsatisfactory results is due to excessive scarring at the site of the created opening (dacryostoma, DS). Mitomycin C is the most extensively studied drug of those affecting regeneration processes, however, the data on its efficacy at DS site is contradictory. Despite ongoing search for new agents able to interfere in the physiological process of scarring, the number of relevant studies is yet insufficient. Thus, development of methods of scarring prevention after endonasal DCR takes the highest priority in dacryology.


Assuntos
Cicatriz/prevenção & controle , Dacriocistorinostomia/efeitos adversos , Mitomicina/uso terapêutico , Ducto Nasolacrimal/cirurgia , Cirurgia Endoscópica por Orifício Natural/efeitos adversos , Cicatriz/etiologia , Humanos , Nariz , Inibidores da Síntese de Ácido Nucleico/uso terapêutico
18.
Vestn Rentgenol Radiol ; (2): 26-30, 2014.
Artigo em Russo | MEDLINE | ID: mdl-25272720

RESUMO

OBJECTIVE: To explore the capabilities of single-photon emission computed tomography (SPECT) in combination with x-ray computed tomography (SPECT/CT) in the study of the anatomy and drainage function of lacrimal passages. MATERIAL AND METHODS: Twelve scans were carried out in 6 healthy volunteers and in patients with different lacrimal drainage disorders (dacryostenoses, varying obstructive lacrimal passage, dacryocystitis and post-dacryocystorhinostomy). Sodium pertechnetate (99mTc) solution and a radiocontrast agent were instilled into the conjunctival sac during the study. RESULTS: SPECT is an objective procedure to study lacrimal drainage function. It cannot provide data on the anatomic structure of lacrimal passages and determine the location of their stenosis or obstruction. SPECT/CT makes it possible to simultaneously obtain information on the anatomic structure of lacrimal passages, to visualize the sites of their pathological changes, and to evaluate the drainage function of lacrimal passages.


Assuntos
Doenças do Aparelho Lacrimal/diagnóstico , Aparelho Lacrimal , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Tomografia Computadorizada por Raios X/métodos , Constrição Patológica/diagnóstico por imagem , Meios de Contraste , Feminino , Humanos , Aparelho Lacrimal/diagnóstico por imagem , Aparelho Lacrimal/fisiopatologia , Doenças do Aparelho Lacrimal/classificação , Doenças do Aparelho Lacrimal/fisiopatologia , Masculino , Pessoa de Meia-Idade , Intensificação de Imagem Radiográfica , Compostos Radiofarmacêuticos , Reprodutibilidade dos Testes
19.
Vestn Oftalmol ; 130(6): 89-97, 2014.
Artigo em Russo | MEDLINE | ID: mdl-25715558

RESUMO

The article presents the results of a monocentric randomized open prospective study conducted from 2008 to 2013. Lacrimal intubation with Mini-Monoka and Monoka silicone stents (mono- or bicanalicular) or with SRS and Ritleng ("FCI", France) stents for dacryostenosis of different localization was performed in 151 patients (203 eyes). The follow-up period was 12 months after the extubation. Patient examination and monitoring included collection of subjective Munk scores for epiphora, lacrimal scintigraphy and bulbar hyperemia evaluation. Though all interventions were proved to be effective, the authors came to the conclusion that, bicanalicular Mini-Monoka and Monoka stents were associated with fewer complications as compared with bicanalicular SRS and Ritleng stents.


Assuntos
Dacriocistorinostomia , Aparelho Lacrimal , Obstrução dos Ductos Lacrimais , Procedimentos Cirúrgicos Minimamente Invasivos , Complicações Pós-Operatórias/prevenção & controle , Stents , Adulto , Idoso , Pesquisa Comparativa da Efetividade , Dacriocistorinostomia/efeitos adversos , Dacriocistorinostomia/métodos , Feminino , Seguimentos , Humanos , Aparelho Lacrimal/diagnóstico por imagem , Aparelho Lacrimal/fisiopatologia , Aparelho Lacrimal/cirurgia , Obstrução dos Ductos Lacrimais/diagnóstico , Obstrução dos Ductos Lacrimais/fisiopatologia , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Monitorização Fisiológica/métodos , Moscou , Complicações Pós-Operatórias/etiologia , Melhoria de Qualidade , Cintilografia , Stents/normas , Stents/tendências , Resultado do Tratamento
20.
Vestn Oftalmol ; 129(5): 104-13, 2013.
Artigo em Russo | MEDLINE | ID: mdl-24261287

RESUMO

The article presents the results of a long-term study on application of cytological examination in dacryology. A total of 194 patients (288 eyes) with dacryostenosis, dacryocystitis, and obliteration of lacrimal canaliculi orifices were assessed. Pathogenically oriented conservative treatment, in accordance with the results of clinical, instrumental, and cytological examination, was given to all patients with dacryostenosis. Patients with dacryocystitis and lacrimal canaliculi orifice obliteration received surgical treatment: microendoscopic dacryocystorhinostomy, transcanalicularis laser dacryocystorhinostomy, and microendoscopic canaliculocystorhinostomy. Cytological examination, among other methods, was used to evaluate treatment results. The method has been demonstrated as objective and can be included into the assessment and follow-up algorithm for patients with lacrimal ducts pathology.


Assuntos
Técnicas Citológicas/métodos , Doenças do Aparelho Lacrimal/patologia , Aparelho Lacrimal/patologia , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Fatores de Tempo
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