当院における小児涙道閉塞性疾患の原因と治療成績

Causes and therapeutic outcome of lacrimal passage obstruction in infants and children in our institution

要約　目的：3歳未満の乳幼児の涙道閉塞性疾患についての原因と治療成績の報告。対象：過去3年間に当院を受診した3歳未満の乳幼児165例を検索した。140例が片側性，25例が両側性で，計190側であった。月齢5か月以上の症例にはプロービングを行った。結果：流涙症の原因は，先天性鼻涙管閉塞154側，涙囊下部閉塞11側，涙小管閉塞6側，涙点閉塞6側で，13側では閉塞部位が不明であった。150側は最初のプロービング，20側は2回以上のプロービング，13側は非侵襲的に，2側はシリコーンチューブ涙道形成で治癒した。結論：3歳未満の乳幼児の涙道閉塞は，涙点閉塞を除き，生後2年以内に適切なプロービングをすることで治癒する可能性が高い。

Abstract.　Purpose：To report the causes and therapeutic outcome of obstruction of lacrimal passage in infants and children in our institution. Cases：This retrospective study was made on 165 infants and children under 3 years of age who were treated for epiphora by us in the past 3 years. One hundred forty cases were unilaterally and 25 cases were bilaterally affected. Patients over 5 months of age were treated by insertion of lacrimal probe. Results：Epiphora was due to congenital nasolacrimal duct obstruction in 154 eyes,obstruction of lacrimal canal in 11,obstruction of lacrimal canaliculi in 6,obstruction of lacrimal punctum in 6,and unknown in 13. Cure was obtained by one session of probing in 150 eyes,after multiple probing in 20,spontaneously in 13,and by silicone tubing in 2. Conclusion：Insertion of lacrimal probe may be effective for obstruction of lacrimal passage before 2 years of age except obstruction of lacrimal punctum.