Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Konjenital Nazolakrimal Kanal Tıkanıklığı Tedavisinde Sondalama Uygulamasının Başarısı: Olgu Serisi
Success Rate of Probing in Congenital Nasolacrimal Duct Obstruction: Case Series
Esra ŞAHLIa, Melek Banu HOŞALa
aAnkara Üniversitesi Tıp Fakültesi, Göz Hastalıkları ABD, Ankara, Türkiye
Turkiye Klinikleri J Ophthalmol. 2022;31(3):134-9
doi: 10.5336/ophthal.2021-87658
Article Language: TR
Full Text
ÖZET
 Amaç: Konjenital nazolakrimal kanal tıkanıklığı (KNLKT) nedeniyle sondalama girişimi uygulanan hastalarda sondalama yaşına göre girişimin başarısını ve başarıyı etkileyen faktörleri değerlendirmektir. Gereç ve Yöntemler: Ankara Üniversitesi Tıp Fakültesi Göz Hastalıkları Kliniği'nde Ocak 2010-Aralık 2019 tarihleri arasında KNLKT tanısıyla sondalama girişimi uygulanan hastaların kayıtları retrospektif olarak değerlendirildi. Hastalar sondalama yaşlarına göre 12- 18 ay, 19-24 ay, 25-48 ay ve 48 ay üstü olacak şekilde 4 gruba ayrıldı. Başarılı sondalama, işlemden 2 hafta sonraki muayenede sulanma şikâyetinin olmaması, epiforanın ve kese bölgesine bastırıldığında punktumdan reflünün gözlenmemesi olarak kabul edildi. Bulgular: Çalışmaya 177 (85 kız ve 92 erkek) hastanın 206 gözü dâhil edildi. Ortalama sondalama yaşı 28,14±14,56 ay (12-61 ay) idi. Sondalama girişiminin başarı oranı tüm gözler için %88,8 olarak saptandı. Buna göre 12-18 ay arası sondalama yapılan gözlerde (n=58) başarı oranı %91,4; 19-24 ay arası sondalama yapılanlarda (n=45) %91,1; 25-48 ay arası sondalama yapılanlarda (n=85) %88,2 ve 48 aydan sonra sondalama yapılanlarda (n=18) %77,8 idi. Kırk sekiz aydan sonra sondalama yapılanlarda başarı oranı daha düşük bulunsa da gruplar arası fark istatistiksel olarak anlamlı değildi (p=0,41). Cinsiyet (p=0,26), sondalama yaşı (p=0,25) ve sağ göz, sol göz ya da bilateral tutulum (p=0,63) başarı üzerinde etkisiz bulunurken, konjonktivit veya kronik dakriyosistit varlığı (p=0,004) ve sondalamayı takiben burundan floresein aspire edilebilmesinin başarı üzerinde etkili olduğu saptandı (p˂0,001). Sonuç: Nazolakrimal kanal sondalama girişiminin başarısı artan yaş ile azalsa da yüksek başarı oranları ile KNLKT tedavisinde ilk 5 yaşta güvenli ve uygulanabilir bir prosedürdür.

Anahtar Kelimeler: Konjenital nazolakrimal kanal tıkanıklığı; sondalama; epifora
ABSTRACT
 Objective: To determine the success rate of probing for congenital nasolacrimal duct obstruction (CNLDO) according to the age at probing and to evaluate the other factors affecting the success rate of probing. Material and Methods: The records of patients who underwent probing with the diagnosis of CNLDO between January 2010 and December 2019 in Ankara University Faculty of Medicine Department of Ophthalmology were assessed retrospectively. The patients were divided into 4 groups based on their age at probing as 12-18 months, 19- 24 months, 25-48 months, and after 48 months. Successful probing was documented as remission of watering complaints, absence of epiphora and reflux from the punctum when pressed on the sac area in the examination 2 weeks after the procedure. Results: A total of 206 eyes of 177 patients were included in the study (85 female and 92 male). The mean probing age was 28.14±14.56 months (12-61 months). The success rate of probing surgery was found to be 88.8% for all patients. The success rate was 91.4% in 12-18 month-olds (n=58); 91.1% in 19-24 montholds (n=45); 88.2% in 25-48 month-olds (n=85); and 77.8% in over 48- month-olds (n=18). Although the success rate was found to be lower in those who had probing at over 48 months, the difference between the groups was not statistically significant (p=0.41). We found that gender (p=0.26), age at probing (p=0.25), or bilaterality (p=0.63) were not effective, but having conjunctivitis or chronic dacryocystitis (p=0.004), and to aspirate fluorescein from the nose after probing were effective on surgical success (p˂0.001). Conclusion: Although the success rates look to be decreasing slightly with age, probing of the nasolacrimal duct is a safe and viable procedure for children under 5 years of age with CNLDO with high success rates.

Keywords: Congenital nasolacrimal duct obstruction; probing; epiphora
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