Congenital Nasolacrimal Duct Obstruction: Common Management Policies Among Pediatric Ophthalmologists
Congenital Nasolacrimal Duct Obstruction: Common Management Policies Among Pediatric Ophthalmologists
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DOI：
10.3928/01913913-20141028-01
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发表时间：
2015-01-01
影响因子：
1.2
通讯作者：
Nelson, Leonard B.
中科院分区：
文献类型：
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作者：
Dotan, Gad;Nelson, Leonard B.
目的：研究先天性鼻泪管阻塞（CNDLO）在儿科眼科医生之间的共同管理政策。方法：2014年4月向美国儿科眼科和斜视协会成员发送了一份包含21个问题的调查。这些问题集中在治疗CNLDO在第一年的生活，小学和中学的手术干预，手术技术，弱视assessment.Results：一百二十七名成员完成了调查，121个答复进行了分析后，6名候选人在培训的答复被排除在外。82%的受访者指示护理人员在出生后的第一年内按摩鼻泪管;然而，55%的人没有在办公室进行克里格勒按摩。接受调查的儿科眼科医生中有17%进行了门诊探查，几乎所有人（95%）都有10年以上的实践经验。91%的人建议在接近1岁时对CNLDO进行手术，79%的人在该年龄进行探查作为初始治疗。如果治疗延迟到2岁，53%的人赞成硅胶管插管和/或球囊泪道成形术。探查失败后，51%的从业者进行了硅胶管插管。百分之九十一的受访者定期检查屈光的婴儿与CNLDO和建议复查，即使最初的评估是完全normal.Conclusions：这项研究突出了显着缺乏共识的儿科眼科医生在许多方面的管理CNLDO，并允许从业者比较他们的实践模式，关于CNLDO管理与他们的同行;然而，因为它只提供了一个有限的儿童眼科医生群体的意见，它并不意味着不太常见的做法是错误的。
Purpose: To study common management policies of congenital nasolacrimal duct obstruction (CNDLO) among pediatric ophthalmologists.Methods: A 21-question survey was sent to members of the American Association for Pediatric Ophthalmology and Strabismus in April 2014. The questions focused on treatment of CNLDO during the first year of life, primary and secondary surgical interventions, surgical techniques, and amblyopia assessment.Results: One hundred twenty-seven members completed the survey and 121 responses were analyzed after replies of 6 candidates in training were excluded. Eighty-two percent of respondents instructed caregivers to massage the nasolacrimal duct during the first year of life; however, 55% did not perform the Crigler massage in the office. Outpatient probing was done by 17% of pediatric ophthalmologists who took the survey, almost all of whom (95%) have been in practice more than 10 years. Ninety-one percent recommended surgery for CNLDO close to the age of 1 year and 79% performed probing as initial treatment at that age. If treatment is delayed to the age of 2 years, 53% favored silicone tube intubation and/or balloon dacryoplasty. Following failed probing, silicone tube intubation was performed by 51% of practitioners. Ninety-one percent of respondents routinely checked refraction of infants with CNLDO and recommended reexamination even if initial assessment was entirely normal.Conclusions: This study highlights the striking lack of consensus among pediatric ophthalmologists in many aspects of management of CNLDO and allows practitioners to compare their practice patterns regarding CNLDO management with those of their peers; however, because it provides only the opinions of a limited group of pediatric ophthalmologists, it does not imply that less common practices are wrong.