Experiences on treatment of lacrimal canaliculus laceration with hidden ends of both upper and lower rupture site

Abstract

Objective To investigate the surgical methods and clinical efficacy for both ruptured upper and lower lacrimal canaliculi with the hidden broken ends. Methods For 12 eyes of 12 cases with both ruptured upper and lower lacrimal canaliculi after trauma, the nasal broken ends were not found by using various methods. The lacrimal sac was incised, retrograde seeking upper and lower canalicular nasal ends was done respectively, and then the upper and lower lacrimal canaliculus anastomosis was applied with dual ring method using a double probe silicone tube.The long-term curative effect after operation was observed. Results Before extubation after surgery, the patients had mild epiphora, foreign body sensation, inner canthus hyperemia, slight shift of silicone tube. There was no dropout of tube. The patients were followed up for 3 months to 1 year after extubation, 10 eyes were cured without tearing, lacrimal duct was unobstructed, and the cure rate was 83.3%. Two eyes were treated effectively with occasional epiphora, stenosis of lacrimal passage with part reflux of washing liquid, and the relative cure rate was 16.7%. Conclusion Lacrimal sac incision combined with double circular tube method in the treatment of both upper and lower lacrimal canaliculi ruptured with hidden nasal broken ends is intuitive and reliable. The concealed supporting tube which does not affect the postoperative appearance, and it avoid the lower eyelid and lower punctum ectropion. Key words: Laceration, upper and lower lacrimal canaliculi; dacryocyst incision; Intubction, dual annular stent