The surgery of lacrimal sac incision and lacrimal duct reconstruction for treating lacrimal duct rupture

ZHENG Zheng; MA Hua-feng; LIU Dan-ning

doi:10.3969/j.issn.1009-4237.2018.06.006

Abstract：Objective To investigate the application of lacrimal passages implantation of tube reconstruc-tion through the incision of lacrimal sac in the complicated lacrimal duct rupture anastomosis .Methods A total of 15 patients (15 eyes) with eyelid laceration and lacrimal duct rupture were collected in our hospital from Jan .2013 to Dec.2016.All patients were unable to find the nasal lacrimal canaliculi after various methods during operation . Then the lacrimal sac was located by the upper lacrimal punctum ,the lacrimal sac was separated and cut open through the wound,the double-probe tear drainage tube was inserted from the upper and lower lacrimal point ,thus the lower drainage tube could directly enter the lacrimal sac through the temporal canaliculi breakage ,and finally tubes were taken out from the nasal cavity and knots were made.Extubation was carried out 3 months after catheter extubation,and postoperative follow-up lasted for 6 months to observe the symptoms of lacrimal passage reconstruc-tion after surgery,the therapy efficiency and complications.Results Among the 15 patients,8 cases had unobstr-ucted lacrimal irrigation,5 cases had no overflow of tears while flushing fluid back flow was observed during the lac-rimal duct flushing,and another 2 cases suffered from failed tear flushing along with slight symptoms of overflowing tears.Conclusion For patients in whom the broken end of naso lacrimal canaliculus can not be found in opera -tion,the lacrimal duct incision reconstruction by lacrimal sac can be used to reconstruct the lacrimal duct of the pa -tient,which can effectively prevent the symptoms of spilled tears.It is a new method of operation.