目的:不少眼科医师在泪道探通时注射眼膏或凝胶以防泪道狭窄,有时溢出于泪道外形成肉芽肿,本文重在探讨其手术治疗方法。方法:我院2004-04/2009-12收治泪道注入眼膏或凝胶后出现的并发症患者9例,其中下睑及内侧硬结,隆起7例,上睑内侧硬结,隆起伴上睑下垂2例,分别于下睑睫毛下1.5mm及上睑重睑线处切开皮肤,分离皮下组织,暴露出硬结隆起处并于同一层面切除,使之平坦;伴上睑下垂者同时予以矫正。切除组织均送病理检查。结果:随访3mo～6a,全部9例患者双眼外观对称,硬结隆起消失,未出现眼睑凹陷及睑外翻,上睑下垂也矫正,效果满意。病理检查结果均为肉芽组织增生。结论:泪道探通时如不按解剖径路,即可形成假道,注入的眼膏或凝胶即可溢出于皮下组织中,刺激组织增生形成肉芽肿,药物中基质可能为主要刺激原,过敏性体质也是原因之一。下睑睫毛下1.5mm及上睑重睑线切口,术后无可见性瘢痕。肉芽肿为团块状,分离后可完整摘除,不会复发。尽早除去肿块是治疗的唯一方法。

AIM:Many ophthalmologists prevent the lacrimal duct stenosis by injecting ointment or gel into lacrimal,but sometimes the formation of granuloma by overflow ointment or gel. In this article,we explore the surgical treatment for this disease. ·METHODS:From April 2004 to December 2009,9 patients with granuloma by overflow ointment or gel in our hospital with medial lower eyelid induration in 7 cases,the medial upper eyelid induration with ptosis in 2 cases,respectively. Skin incision was taken under the lower eyelid eyelashes (1.5mm)and the upper double eyelid line; subcutaneous tissue was separated; after that,the induration was exposed and removed; Upper eyelid ptosis was corrected. Removed tissues were sent for pathological examination. ·RESULTS:After followed up for 3 months to 6 years,all 9 patients had symmetrical appearence with the induration and bulge disappeared,and the eyelid of depression and ectropion did not occur. Ptosis had the satisfactory effect. Pathological results were granulation hyperblastosis. ·CONCLUSION:False passage formed by the uncorrected probing of lacrimal passages without anatomy path,after that,the injected ointment or gel can overflow into the subcutaneous,and stimulate the granuloma proliferation.The original matrix of drugs may be the main stimulus;Besides,allergic constitution is also one of the main reasons. No visible scars occur after surgery on the ower eyelid and upper eyelid line under (1.5mm). After complete removal of mass granuloma,no relapse occurred. Removing the tumor quickly is the only treatment method of this disease.

R779.6