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  • 1 Általános Orvostudományi Kar, Szemészeti Klinika, Semmelweis Egyetem, Budapest, Mária u. 39., 1085
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Összefoglaló. Bevezetés: Csecsemőkorban a könnyezés gyakori oka a könnycsatorna veleszületett elzáródása, mely az esetek nagy részében 1 éves korra spontán oldódik. Célkitűzés: Retrospektív tanulmányunk célja a monocanalicularis szilikonsztent (Masterka®) implantációjával kapcsolatos eredményeink bemutatása. Módszer: 2015. január 1. és 2020. január 30. között monocanalicularis szilikonsztent implantációján átesett gyermekek adatait dolgoztuk fel. Bevonási kritériumként szerepelt a legalább 6 hónapja fennálló, konzervatív kezelésre nem szűnő könnyezés és emiatt előzetesen elvégzett szondázás, mely után a panaszok kiújultak. Kizárási kritérium volt a csontosan elzárt ductus nasolacrimalis és a hibás szemhéjállás. A műtét hatékonyságát a szilikonsztent eltávolítását követő legalább 2 hónap panaszmentességgel definiáltuk. Eredmények: 25 gyermek (10 lány [40%] és 15 fiú [60%]) összesen 30 szemén végeztünk szilikonsztent-beültetést. Az átlagéletkor 4,92 ± 3,03 év (1,5–12 év, n = 25) volt. Minden páciens a születése óta könnyezett. A műtét előtt váladékképződést 20 (66,67%, n = 30), krónikus szemhéj- és kötőhártya-gyulladást 10 (33,33%, n = 30) esetben észleltünk. Tompalátást, jelentős astigmiát nem találtunk. A sztentet átlagosan 3,5 ± 1,0 (n = 30) hónap után távolítottuk el. A műtétet követően 1 héttel 24 (80%, n = 30), 3 hónappal 28 (93,33%, n = 30) és 6 hónappal 24 (88,89%, n = 27) szem volt tünetmentes. Következtetés: A Masterka® implantációja egyszerűen kivitelezhető, kifejezetten hatékony módszer lehet az 1 évnél idősebb gyermekek veleszületett könnycsatorna-szűkületének megoldására, különösen olyan esetekben, amikor a korábbi szondázás nem vezetett eredményre, valamint hosszabb szakaszon észlelünk szűkületet. Ez utóbbi esetekben megfontolandó lenne a primer szilikonsztent-implantáció is. Orv Hetil. 2020; 161(48): 2037–2042.

Summary. Introduction: Congenital nasolacrimal duct obstruction is a common cause of epiphora in infants. In most cases, spontaneous resolution occurs by 1 year of age. Objective: Retrospective evaluation of clinical outcomes of monocanalicular lacrimal duct stent implantation (Masterka®). Method: Data of patients undergoing monocanalicular silicone stent implantation between 1st January 2015 and 30th January 2020 were evaluated. Inclusion criteria were resistant tearing to conservative therapy which had been persisting at least for 6 months, and previous probing did not resolve the symptoms. Exclusion criteria were associated bony obstruction or eyelid malposition. Treatment success was defined as complete resolution of epiphora at least two months after the procedure. Results: Implantation was performed on 30 eyes of 25 children (10 females [40%] and 15 males [60%]). The mean age was 4.92 ± 3.03 years (1.5–12 years, n = 25). Epiphora was a persistent symptom in every patient since birth. Preoperatively, discharge was observed in 20 (66.6%, n = 30) patients, while chronic blepharitis and conjunctivitis occurred in 10 (33.33%, n = 30) children. Amblyopia or significant astigmatism was not observed in any case. Stent was removed after 3.5 ± 1.0 (n = 30) months. At one week postoperatively 24 (80%, n = 30), at 3 months 28 (93.33%, n = 30) and at 6 months 24 (88.89%, n = 27) eyes were asymptomatic. Conclusion: Implantation of monocanalicular silicone stent is effective and easy-to-perform. It can resolve congenital tear duct stenosis, especially where previous probing was not successful and where stenosis is longer or occurs in several localizations. In the latter cases, primary stent implantation should be considered. Orv Hetil. 2020; 161(48): 2037–2042.

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