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DOI: 10.1055/s-0031-1273215
© Georg Thieme Verlag KG Stuttgart · New York
Improvement of Chronic Epiphora Symptoms after Surgery in Patients with Different Preoperative Schirmer-Test Values
Symptomverbesserung von chronischer Epiphora durch chirurgische Therapie in Patienten mit unterschiedlichen präoperativen Schirmer-Test-WertenPublication History
received: 1.10.2010
accepted: 24.1.2010
Publication Date:
11 April 2011 (online)
![](https://www.thieme-connect.de/media/klimo/201104/lookinside/thumbnails/10.1055-s-0031-1273215-1.jpg)
Zusammenfassung
Hintergrund: Vergleich der Epiphora-Symptomverbesserung nach Operation von Patienten mit unterschiedlichen präoperativen basalen Schirmer-Test-Werten. Patienten und Methode: Design: Retrospektive, vergleichende Fallserie-Studie. Teilnehmer: 22 konsekutive Patienten (ein Auge/Patient) mit chirurgischer Therapie aufgrund chronischer, therapieresistenter Epiphora. Einteilung in 2 Gruppen anhand der präoperativen basalen Schirmer-Test-Werte (Oxybuprocain-HCl 0,4 %): Gruppe I: 0 – 6 mm (n = 11), Gruppe II: 7 – 25 mm (n = 11). Eingriff: Kombination von Piffarettis transpunktaler endoskopischer lacrimaler Drainage (n = 22), lacrimaler Intubation (n = 8), lacrimaler Punktoplastik (n = 22), lateraler Kanthoplastik (n = 18) und/oder Konjunktivochalasis-Chirurgie (n = 8). Outcome: Subjektive Symptomverbesserung der Epiphora 1 Jahr postoperativ. Ergebnisse: Während die mittleren (± SD) präoperativen basalen Schirmer-Test-Werte zwischen Gruppe I und II signifikant unterschiedlich waren (4 ± 3 mm vs. 10 ± 6 mm, p ≤ 0.001, Mann-Whitney-Test), zeigte die postoperative Epiphora-Symptomverbesserung keinen signifikanten Unterschied (82 % ± 30 % vs. 76 % ± 34 %, p = 0,92). Die Korrelation von Schirmer-Test-Werten und Symptomverbesserung war nicht signifikant (rho = -0,11, p = 0,62, Spearman-Koeffizient). In beiden Gruppen berichteten > 70 % der Patienten über eine ≥ 70 % (zufriedenstellende) Symptomverbesserung. Schlussfolgerung: In dieser Studie zeigten Patienten mit unterschiedlichen basalen Schirmer-Test-Werten eine ähnliche Epiphora-Symptomverbesserung ein Jahr postoperativ.
Abstract
Background: To compare improvement of epiphora symptoms after surgery between patients who had different preoperative basal Schirmer test values. Patients and Methods: Design: Retrospective comparative case-series study. Participants: Twenty-two consecutive patients (one eye/patient) undergoing surgery for chronic epiphora symptoms resistant to ≥ 6 months of medical treatments (who incidentally had a preoperative basal [oxybuprocain-HCL 0.4 %] Schirmer-test and a postoperative one-year follow-up) were ranked according to their preoperative basal Schirmer test values and divided into two groups of equal size: group I, patients with lower (0 to 6 mm) and group II, patients with higher (7 to 25 mm) Schirmer test values. Intervention: Combination of Piffaretti’s endocanlicular endoscopic lacrimal drainage (22 patients), lacrimal intubation (8 patients), lacrimal punctoplasty (22 patients), lateral canthoplasty (18 patients), and/or conjunctivochalasis (8 patients) surgical procedures. Outcome: Subjective self-perceptions of improvement of their epiphora symptoms was made by the patients one-year after surgery. Results: While between groups I and II mean (± SD) preoperative basal Schirmer test values significantly differed (4 ± 3 mm/ 5 min vs. 10 ± 6 mm/ 5 min, p ≤ 0.001, Mann-Whitney rank sum test), the mean postoperative improvement of epiphora symptoms did not (82 ± 30 % vs. 76 ± 34 %, p = 0.92) and no significant (rho = -0.11, p = 0.62, Spearman rank correlation coefficient) correlation between Schirmer test values and symptoms improvement was found. In both groups > 70 % of patients reported ≥ 70 % (satisfactory) postoperative improvement. Conclusions: In the present study, patients who had different preoperative basal Schirmer test values reported having very similar epiphora symptoms improvement one-year after surgery.
Schlüsselwörter
funktionelle Epiphora - Trockenauge - Feuchtauge - lacrimale Chirurgie - Ballon-Kanthoplastie - nasolacrimalr Intubation - Konjunktivochalasis - Ektropion
Key words
functional epiphora - dry eye - watery eye - lacrimal surgery - balloon canthoplasty - nasolacrimal intubation - conjunvtivochalasis - ectropium
References
- 1 Delaney Y M, Khooshabeh R. External dacryocystorhinostomy for the treatment of acquired partial nasolacrimal obstruction in adults. Br J Ophthalmol. 2002; 86 533-553
- 2 Haefliger I O, Piffaretti J M. Lacrimal drainage system endoscopic examination and surgery through the lacrimal punctum. Klin Monatsbl Augenheilkd. 2001; 218 384-387
- 3 Haefliger I O, Tatrai D, Figueiredo A R et al. A surgical approach to treat chronic epiphora and/or muculopurulent discharge in patients with permeable lacrimal drainage system. Klin Monatsbl Augenheilkd. 2007; 224 234-236
- 4 Haefliger I O, Vysniauskiene I, Figueiredo A R et al. Superficial conjunctiva cauterization to reduce moderate conjunctivochalasis. Klin Monatsbl Augenheilkd. 2007; 224 237-239
- 5 Kanski J J. Disorders of the lacrimal drainage system. In: Clinial Ophthalmology, A Systematic Approach (Third Edition).. Boston MA: Butterworth-Heinemann; 1997: 59-69
- 6 Kielhorn I, Rowson N J. Lateral canthal surgery in the management of epiphora. Orbit. 2002; 21 111-116
- 7 Liu D. Conjunctivochalasis. A cause of tearing and its management. Ophthal Plast Reconstr Surg. 1986; 2 25-28
- 8 Nichols K K, Nichols J J, Mitchell G L. The lack of association between signs and symptoms in patients with dry eye disease. Cornea. 2004; 23 762-770
- 9 Shapiro A, Dan J A. Restoration of the patency of the nasolacrimal drainage system. Ophthal Plast Reconstr Surg. 1997; 13 210-215
Ivan O. Haefliger, MD, FEBO
Leonhards-PraxisKLINIK
Holbeinstrasse 29
4051 Basel
Switzerland
Phone: ++ 41/61/2 71 87 58
Fax: ++ 41/61/2 71 87 59
Email: ivan.haefliger@bluewin.ch