Bicanalicular Lacerations: Clinical Characteristics and Surgical Outcomes With a New Bicanalicular Silicone Stent.

Abstract

Bicanalicular lacerations are relatively rare and more of a surgical challenge in clinical practice. The purpose of this study is to evaluate the clinical characteristics and surgical outcomes of bicanalicular lacerations with a new bicanalicular silicone stent at a tertiary eye care center. All patients who underwent bicanalicular lacerations repair from January 2013 and December 2018 were retrospectively reviewed. Data collected for each patient included patient demographics, affected sides, cause of injuries, the timing of management, associated ocular injuries, the timing of stent removal, duration of follow-up and the outcomes of the surgical repair with a new bicanalicular silicone stent. Thirty-six patients with bicanalicular lacerations met the inclusion criteria and were enrolled in the study. The mean age of the patients was 43.8 years old (range: 2-73years). Of the 36 patients, 33 (91.7%) were males and 3 (8.3%) were females. The right eye was injured in 17 patients (47.2%). All patients underwent surgical intervention within 24 hours. The most common cause of bicanalicular lacerations was electric bicycles accidents (7 patients, 19.4%), and followed by motor vehicle accidents (6 patients, 16.7%), blunt objects (6 patients, 16.7%), fights (6 patients, 16.7%), falls (3 patients, 12%), dog bites (2 patients, 5.6%), hook injuries (2 patients, 5.6%), broken glass (2 patients, 5.6%), and sharp objects (2 patients, 5.6%). The most common associated ocular injuries were orbital fracture (61.1%), followed by lid lacerations and open globe injuries. The functional success rate was 86.1%. The average interval between the surgery and the stent removal was 13.8 weeks (range: 8-20 weeks). All the stents were removed successfully without any difficulty in the outpatient department. The follow-up after stent removal ranged from 2 to 12 months (mean: 5.1months). Bicanalicular lacerations involvement occured in 6.8% of all canalicular lacerations. The most common cause of bicanalicular lacerations was electric bicycles accidents and the most common associated ocular injuries was orbital fracture in North China. The new bicanalicular silicone stent achieved good functional success (86.1%) in the management of bicanalicular lacerations.