目的:评估Smart plug泪小管塞治疗水液缺乏型干眼的长期并发症。方法:收集汕头国际眼科中心2011至2016年门诊确诊的水液缺乏型干眼患者300例(600眼),进行Smart plug泪小管塞治疗,随访观察术后临床并发症,中位随访时间为术后3年(术后1~5年)。结果:3例患者(3眼)术后患有泪小管炎(0.5%),发病时间为术后1~3(中位2)年,取出泪小管塞后并给予局部抗生素滴眼液治愈。2例患者 (4眼)因植入上下泪小管塞后流泪症状不能耐受,单纯取出下泪小管塞后症状缓解(0.7%);4例患者(8眼)因只植入下泪小管塞症状未能明显好转,1个月后再次植入上泪小管塞(1.3%);291例患者干眼主观症状改善,有效率为97.5%,长期随访未发现并发症。结论:虽然Smart plug泪小管塞治疗水液 缺乏型干眼具有明确的疗效,但Smart plug泪小管塞植入后的长期并发症不容忽视,需要长期观察。
Objective: To evaluate the long-term complication associated with the use of the Smart plug in the treatment of aqueous tear deficiency dry eye. Methods: A total of 300 patients (600 eyes) were collected in Joint Shantou International Eye Center from 2011 to 2016, all the patients accepted the treatment with Smart plug, and were followed up for clinical complications. The median follow-up time was postoperative 3 years (1–5 years after surgery). Results: Three patients (3 eyes) developed canaliculitis, the rate was 0.5%. The median time from Smart plug insertion to the onset of canaliculitis was 2 (1–3) years, leaving the Smart plug and resolved the application of topical antibiotics. Two patients (4 eyes) could not suffer from implantation of the upper and lower Smart plug, removed the below, the ratio was 0.7%; 4 patients (8 eyes) need upper Smart plug insertion after implantation of the lower one month later, the rate was 1.3%; 291 cases of dry eye improved by long-term followup, the effective rate was 97.5%. Conclusion: Although the Smart plug is effective in the treatment of aqueous tear deffciency dry eye, the later complications of Smart plug insertion cannot be neglected and need the long-term follow-up.
猫抓病(cat scratch disease,CSD)是由巴尔通体引起的一种人畜共患病。该病不仅有多种全身表现,还可能出现各种危害视力的眼部并发症。随着家庭饲养宠物不断增多,CSD发病率逐年上升,眼科医生应重视此病。CSD的临床表现多种多样,容易误诊,与猫等宠物接触的病史、高滴度的血清免疫球蛋白G抗体是诊断的关键,聚合酶链反应也有助于诊断。由于CSD通常是免疫能力强的个体的自限性感染,因此通常不需要抗生素治疗。然而,当免疫力低或感染重时,多西环素是最常用的抗生素。
Cat scratch disease (CSD) is a zoonotic disease caused by Bartonella, which not only has a variety of systemic manifestations, but also may have various ocular complications that endanger vision. With the increasing number of pets kept at home, its incidence shows an increasing trend year by year. Therefore, ophthalmologists should pay attention to this disease. The clinical manifestations of CSD are various, which easily lead to misdiagnosis. The medical history of contact with cats and other pets and serum immunoglobulin G antibody with high titer are the key to diagnosis, and polymerase chain reaction is also helpful to diagnosis. Because CSD is usually a self-limiting infection of individuals with strong immune ability, antibiotic treatment is usually not required. However, when immunity is low or infection is severe, doxycycline is the most commonly used antibiotic.