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눈물주머니조영술에서의 눈물길 폐쇄 위치에 따른 코경유눈물주머니코안연결술의 효과

Surgical Outcomes of Endonasal Dacryocystorhinostomy According to the Level of Obstruction in Dacryocystography

대한안과학회지 2018년 59권 4호 p.301 ~ 306
KMID : 0360220180590040301
배경화 ( Bae Kyoung-Hwa ) - 전북대학교 의학전문대학원 안과학교실

조남천 ( Cho Nam-Chun ) - 전북대학교 의학전문대학원 안과학교실
안민 ( Ahn Min ) - 전북대학교 의학전문대학원 안과학교실

Abstract

Purpose: The success of endonasal dacryocystorhinostomy was assessed according to the level of tear duct obstruction in dacryocystography.

Methods: Patients visited our clinic with the chief complaint of epiphora between January 2009 and September 2016 who received dacryocystography and were diagnosed with a total nasolacrimal obstruction. Among these patients, 128 eyes from 115 patients who received endonasal dacryocystorhinostomy were selected and their medical records from > 6-month follow-ups were analyzed retrospectively. The patients were divided into four groups according to the level of lacrimal passage obstruction in dacryocystography: common canaliculus obstruction as group 1, lacrimal sac obstruction as group 2, lacrimal sac-nasolacrimal duct junction obstruction as group 3, and nasolacrimal duct obstruction as group 4. Success and failure were determined according to symptom improvements after surgery.

Results: Among the total of 128 eyes, 19 eyes were categorized as group 1 (22.6%), 28 eyes as group 2 (21.9%), 28 eyes as group 3 (21.9%), and 43 eyes as group 4 (33.6%). Nasolacrimal duct obstruction was the most common condition. The success of endonasal dacryocystorhinostomy was 55.2% in group 1, 71.4% in group 2, 85.7% in group 3, and 86.1% in group 4. The surgical success of the patient group with common canaliculus obstruction was significantly lower than the surgical success of the lacrimal sac-nasolacrimal duct junction obstruction and nasolacrimal duct obstruction groups (p = 0.03 and p = 0.01, respectively).

Conclusions: Determination of the accurate position of obstruction using preoperative dacryocystography is recommended for patients with epiphora caused by tear duct obstruction because this predicted the effects of endonasal dacryocystorhinostomy.
KeyWords

Dacryocystography, Dacryocystorhinostomy, Nasolacrimal obstruction
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학술진흥재단(KCI) KoreaMed 대한의학회 회원