Abstract
Purpose To report the epidemiological and clinical data as well as surgical outcomes of canalicular lacerations with Mini-Monoka insertion at a tertiary center in Taiwan and to discuss differences in traumatic pattern, pathogenesis, and surgical outcomes between Taiwan and other countries. Methods From 2009 to 2018, all 48 patients who underwent canalicular laceration repair with Mini-Monoka stent at a tertiary center in Taiwan were retrospectively analyzed. Demographic and clinical data and surgical outcomes were recorded. Results The mean age of the 48 patients was 38 years. Single lower canaliculus was involved in 37 (77.1%) patients, upper canaliculus in 10 (20.8%) patients, and both in 1 (2.1%) patient. The most common etiology was motorcycle accident (41.7%), and all traffic accident injuries accounted for 68.75% of cases. Subgroup classification revealed 64.6% of patients (n=31) were categorized in the deep laceration group, and lower anatomical and functional outcomes were noted in deep laceration. The mean follow-up time was 14.5 months. Overall, the anatomical success rate was 87.5%, and the functional success rate was 91.7% after stent removal. Conclusion Canalicular laceration caused by traffic accidents occurred with a relatively high frequency in Taiwan. Affected patients tended to be middle-aged, and deep laceration accounted for 64.6% of patients. These were contributed by the avulsive eyelid injury mechanism caused by traffic accidents. Furthermore, the deeper lacerated site was located, and the lower anatomical and functional success rates were observed. Early repair after trauma with Mini-Monoka stents achieved good eyelid position (100%) as well as good anatomical (87.5%) and functional (91.7%) success without serious complication.
Highlights
Eyelid injuries are sometimes accompanied by canalicular laceration because the canaliculus sits just beneath the thin layer of the eyelid skin without additional protection [1]. e lower canaliculus is especially vulnerable to direct penetrating and indirect or diffuse avulsive blunt injury to pericanalicular soft tissue in the lacrimal drainage system [1, 2]
Patients whose follow-up duration was shorter than 6 months were excluded. e data collected included demographics, cause of eyelid injury, distance between lateral canalicular lacerated end and punctum, duration from injury to surgery, associated ocular injury, surgical outcomes, time of stent removal, and follow-up duration
We classi ed our patients into 3 subgroups on the basis of distance from the lateral end of canalicular laceration to the punctum. ere were no patients in the shallow laceration group, which was de ned as a distance from the lacerated end to the punctum measuring less than 4 mm. ere were 17 patients in the moderate laceration group, which was de ned as a distance from the lacerated end to the punctum measuring 4–7 mm. ere were 31 patients in the deep laceration group, which was
Summary
Eyelid injuries are sometimes accompanied by canalicular laceration because the canaliculus sits just beneath the thin layer of the eyelid skin without additional protection [1]. e lower canaliculus is especially vulnerable to direct penetrating and indirect or diffuse avulsive blunt injury to pericanalicular soft tissue in the lacrimal drainage system [1, 2]. Eyelid injuries are sometimes accompanied by canalicular laceration because the canaliculus sits just beneath the thin layer of the eyelid skin without additional protection [1]. E lower canaliculus is especially vulnerable to direct penetrating and indirect or diffuse avulsive blunt injury to pericanalicular soft tissue in the lacrimal drainage system [1, 2]. A number of sequelae such as ectropion, epiphora, and poor cosmetic appearance could occur. Most ophthalmologists recommend immediate management with stenting of the lacerated canaliculus to successfully restore proper eyelid anatomy, prevent medial ectropion, and prevent canalicular obstruction [6, 7]. Lacrimal drainage system blockage will result in epiphora due to canalicular stenosis, pericanalicular scarring band, or malposition of the punctum [1]
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