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A Survey of Pediatric Ophthalmologists to Assess Practice Patterns for Primary Surgical Management of Nasolacrimal Duct Obstruction.
Journal of Pediatric Ophthalmology and Strabismus ( IF 1.2 ) Pub Date : 2021-08-26 , DOI: 10.3928/01913913-20210611-01
Elizabeth Pogrebniak , Eric Crouch

PURPOSE To survey current practice patterns of pediatric ophthalmologists regarding primary surgical management of infantile dacryostenosis. METHODS Responses to a five-question survey were cross-tabulated to compare surgery preferences across patient age ranges and intubation method. Surveys were submitted to members of the American Association for Pediatric Ophthalmology and Strabismus following institutional review board approval. RESULTS Results from 142 completed surveys were analyzed. A bimodal distribution of reported propensity to intubate the nasolacrimal duct during primary surgery for dacryostenosis was observed, with one group of ophthalmologists intubating frequently and a second group intubating rarely. For patients younger than 24 months, 33 of 142 surgeons (23%) preferred to intubate 91% or more of the time and 76 of 142 (54%) preferred to intubate 10% or less of the time. For patients older than 24 months, the overall preference for intubation increased compared to the younger patient age group (P < .0007). In older patients, 52 of 142 surgeons (37%) preferred to intubate 91% or more of the time and 45 of 142 surgeons (32%) preferred to intubate 10% or less of the time. The most common preferred intubation methods were self-threading monocanalicular stent (42%) and metal-swaged bicanalicular stent (21%). Surgeons who preferred self-threading monocanalicular stents more often also preferred intubation procedures. CONCLUSIONS Best practice for infantile dacryostenosis remains a surgeon preference, with some surgeons performing intubation frequently and others performing it rarely. Overall estimated intubation rates for primary surgery increased from 36% in children younger than 24 months to 50% at age 24 months or older. [J Pediatr Ophthalmol Strabismus. 2022;59(1):35-40.].

中文翻译:

一项儿科眼科医生的调查,以评估鼻泪管阻塞初级手术治疗的实践模式。

目的 调查儿科眼科医生目前关于婴儿泪囊狭窄初级手术治疗的实践模式。方法 对一项包含五个问题的调查的反应进行交叉制表,以比较患者年龄范围和插管方法的手术偏好。在机构审查委员会批准后,调查已提交给美国儿科眼科和斜视协会的成员。结果 对 142 项已完成调查的结果进行了分析。观察到在泪道狭窄初次手术期间鼻泪管插管倾向呈双峰分布,一组眼科医生经常插管,另一组很少插管。对于小于 24 个月的患者,142 名外科医生中有 33 名 (23%) 愿意在 91% 或更多的时间插管,142 名外科医生中有 76 名 (54%) 更愿意在 10% 或更少的时间插管。对于 24 个月以上的患者,与年轻患者年龄组相比,对插管的总体偏好增加(P < .0007)。在老年患者中,142 名外科医生中有 52 名 (37%) 愿意在 91% 或更多的时间进行插管,142 名外科医生中有 45 名 (32%) 喜欢在 10% 或更少的时间进行插管。最常见的首选插管方法是自穿式单管支架 (42%) 和金属型锻双管支架 (21%)。更喜欢自穿式单管支架的外科医生通常也更喜欢插管程序。结论 婴儿泪囊狭窄的最佳实践仍然是外科医生的偏好,一些外科医生经常进行插管,而另一些则很少进行。总体估计初次手术插管率从 24 个月以下儿童的 36% 增加到 24 个月或以上年龄的 50%。[J 小儿眼科斜视。2022;59(1):35-40.]。
更新日期:2021-08-01
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