Clinical Application Value of a Preset Marking Line in Lacrimal Endoscopic Surgery

Abstract

Objective: To explore the clinical application value of a preset marking line in lacrimal endoscopic surgery and evaluate its effect on surgical complications. Methods: This was a prospective analysis of clinical data from 60 patients (60 eyes) with lacrimal duct obstruction who had lacrimal endoscopic surgery in Changshu No.2 People's Hospital from June 2015 to December 2018. All patients were divided into two groups, a control group or observation group according to the even or odd numbers assigned to hospital patients. The control group (odd numbers) had no intra-surgery preset marking line. The observation group (even numbers) had an intra-surgery preset marking line. The complications of lacrimal duct mucosa injury, hemorrhage, perforation (false passage), eyelid edema and postoperative hemorrhage were observed and recorded. The data were analyzed by a Chi-square test. Results: In the observation group, the number of preset marking lines could be clearly observed during surgery, and combined with the position of the lacrimal endoscope, could be determined by the anatomical characteristics of the lacrimal passage. One marker line could be observed in the lacrimal canaliculi. The convergence of two marker lines could be observed in the common canaliculus. Two marker lines with an enlarged space could be observed in the lacrimal sac. Two marker lines with mucosal folds could be observed in the nasolacrimal duct. The incidence of lacrimal mucosal injury was 16% (χ2=8.543, P=0.003), hemorrhage incidence was 13% (χ2=8.718, P=0.003) and eyelid edema incidence was 10% (χ2=4.069, P=0.044) in the observation group, which were significantly lower than the incidences in the control group (52%, 52% and 35%, respectively). One case of perforation (false passage) occurred in the control group, which was not statistically significant compared with the observation group (χ2=0.001, P=0.973). There was no statistically significant difference in the incidence of postoperative hemorrhage between the groups (χ2=1.898, P=0.168). Moreover, all patients in the two groups had a small amount of hemorrhage, which did not affect the operation after intraoperative water injection. Patients with a small amount of postoperative hemorrhage stopped bleeding within 2 days. Conclusions: The application of preset marking lines for lacrimal endoscopic surgery can better control the endoscopic examination and surgery, and can accurately identify the location site of the surgery, which can reduce the incidence of surgical complications. Key words: lacrimal endoscope; lacrimal duct stents; preset marker line; lacrimal duct obstruction