Lacrimal Canalicular Laceration Research Articles

Intravenous Catheter Use for Inferior Lacrimal Canalicular Laceration Reconstruction: A Life Hack in Low Resource Setting

Introduction : Silicone tube was the standard for stenting canaliculi in lacrimal canalicular laceration. But it was not always in stock at a hospital in remote area with low resource. Use of intravenous catheter to exchange the unavailable slicone tube was a possible option.
 Case Illustration : We reported two cases of inferior canalicular laceration at NTB provincial hospital. Both cases were adult, one female and one male. First case caused by nail and second because of traffic accident. There were no globe involvement in both case. Reconstruction surgeries with monocanalicular approach were performed. Intravenous catheter was used for stenting the canaliculus. First case was using a 24G, the other was 22G. The catheters were well inserted and planned to be removed at3 month. At the day 7 follow-up, the 24G catheter was extruded spontaneously while the patient with 22G was not. Both patients did not complain of profuse tearing.
 Discussion : The diameter and length of 24G iv catheter were 0.7mm and 19mm, while 22G were 0.9mm and 25mm. The diameters were similar with the silicone tube (0.6mm) and the lengths were long enough to pass the lower and common canaliculus which has a total 15mm long. The catheter in the first case was extruded possibly because in 24G there was only 4mm inside th lacrimal sac. A high pressure air from the nose would push the catheter backward and extruded. The 22G would have 10mm inside the sac.
 Conclusion : Intravenous catheter was an alternative option for inferior canalicular laceration stenting in low resource setting.

A case series study of lacrimal canalicular laceration repair with the bi-canalicular stent

Lacrimal canalicular laceration can be caused by trauma on the ocular adnexa, such as penetrating or blunt injuries, accounting for approximately 16% of eyelid lacerations and 20% of eye traumas. Historically, canalicular anastomosis combined with bi-canalicular or mono-canalicular stent intubation has been used for canalicular laceration repair. In this study, we analyzed the epidemiological characteristics of lacrimal canalicular laceration and evaluate the clinical outcomes of repair using the bi-canalicular stent in central China. It aims to provide a reference for clinical work. This is a review of 338 patients (338 eyes) with eyelid lacrimal canaliculus laceration undergoing reparative bi-canalicular stent intubation from January 1st 2017 to December 30th 2020. The analyzed data included demographics, the place of occurrence of the trauma, the mechanism of injury, additional injury, and surgical outcomes at follow-up. The outcomes included anatomic success, functional success, and complications. The average age was 39.6±20.0 years (1 to 88 years). Of all the 338 patients, 254 (75.15%) patients were men. Upper and lower canalicular lacerations were seen in 68 (20.12%) and 256 (75.74%) patients, respectively. Also, 14 patients (4.14%) presented with both upper and lower canalicular lacerations. Most injuries occurred on the streets (146, 43.20%), followed by the home in 111 (32.84%) patients. Traffic accidents were the leading cause of injury (127, 37.57%), including 72 (21.30%) cases of electric bike-associated accidents, followed by fall-related trauma in 65 (19.23%) cases. During the follow-up, there were 6 (1.78%) patients with eyelid ectropion and 9 (2.66%) patients with stent extrusion and loss due to eye rubbing and pulling the sutures out. At the end of follow-up, the anatomical success rate was 95.86% and the functional success rate was 89.64%. Electric bike-associated accidents occurring on the streets is the current leading cause of injury in central China. Lacrimal canalicular laceration repair with a bi-canalicular stent offers an effective surgical therapeutic strategy for traumatic canalicular lacerations. In addition, avoiding traffic accidents is also one way prevent lacrimal canalicular laceration.

Anatomical and Functional Success Analysis of Lacrimal Canalicular Lacerations Repaired with Bicanalicular Stents in a Tertiary Referral Teaching Center in Mexico.

Functional and anatomical success after canalicular laceration repair using only Crawford bicanalicular stents was evaluated in a ophthalmological teaching center. The objective of this study was to evaluate functional and anatomical success after canalicular laceration repair using Crawford bicanalicular stents. Records of patients with canalicular laceration repair performed from 2010 to 2019 at Ophthalmology Institute Conde de Valenciana in Mexico City were reviewed. Demographic data, injury mechanism and complications were recorded. Anatomical success was assessed with canalicular irrigation and functional success was evaluated using Munk score. Phi correlation coefficient was used to compare the correlation between epiphora and lack of permeability of injured canaliculus and the presence of complications at 6th month postoperative visit. Two-hundred eight patients with lacrimal canalicular injury reconstruction were documented during the study period. The most common age of presentation and etiology was from 21 to 30 years old and injury with a sharp object, respectively. 96 patients were included for the correlation analysis. At 6th month, anatomical success was found in 75% and functional success was found in 77.8%. A statistically significant and directly proportional linear was found between the presence of epiphora and lack of permeability of injured canaliculus, (rφ 0.76, p <0.05) and between the presence of epiphora and postoperative complications, (rφ 0.509, p <0.05). Crawford bicanalicular stents are a valid and accessible option for canalicular laceration repair. Our success rate of lacrimal canalicular lacerations repaired with bicanalicular stents in a Mexican teaching hospital matches worldwide literature. Factors involved in the functional and anatomical success of the reconstruction include presence of postoperative complications and permeability of canaliculus after surgery.

Eiology and prognosis of canalicular laceration repair using canalicular anastomosis combined with bicanalicular stent intubation

BackgroundTo evaluate the etiology of lacrimal canalicular laceration and explore the possible risk factors influencing prognosis.MethodsThe data of 142 patients (142 eyes) with lacrimal canalicular lacerations who were surgically treated using canalicular anastomosis combined with bicanalicular stent intubation between March 2017 and March 2018 were reviewed. The analyzed data contained demographic information, types of trauma, injury locations, associated additional ocular injuries, and surgical outcomes at follow-up. The main outcome measures were anatomic success rate, functional success rate, and complications of surgery.ResultsThe mean patient age was 42.07 years (ranging from 1 to 75 years). Among the 142 patients, 112 (78.87%) were males. Upper and lower canalicular lacerations were found in 14 (9.86%) and 112 (78.87%) patients, respectively. Meanwhile, both upper and lower canalicular lacerations were found in 16 (11.27%) patients. Electric bike accidents comprised the leading cause of injury, accounting for 76 (53.52%) cases. There were 100 (70.42%) patients who had lid lacerations without tarsal plate fracture and 42 (29.58%) patients who had lid lacerations with tarsal plate fractures. The anatomic success rate was 98.59% and the functional success rate was 83.8%. The functional reconstruction failure rates were higher in patients with indirect injuries, lid lacerations with tarsal plate fractures, and those with punctum splitting (P < 0.05). Surgical complications were detected in the form of lacrimal punctum ectropion in 3 (2.11%) patients, punctum splitting in 2 (1.41%) patients, and stent extrusion and loss in 2 (1.41%) patients.ConclusionsElectric bike accidents have become the leading cause of injury instead of motor vehicle accidents because of the changes in the lifestyles of people. Indirect injuries, lid lacerations with tarsal plate fractures, and those with punctum splitting were significantly more likely to lead to poor prognosis, as confirmed by the lower functional success rate of surgery.

Results of Traumatic Canalicular Laceration Repair Performed by Trainees in a Tertiary Eye Care Center

Background: Lacrimal canalicular laceration is a common condition in emergency medicine. Many eyelid lacerations involve the lacrimal canalicular system. In the authors’ institution, nearly all cases of lacrimal canalicular laceration are treated by ophthalmology trainees, and are followed-up periodically in the post-operative period. Objective: To analyze the success rate of the cases of lacrimal canalicular laceration treated by trainees in a tertiary eye care center in Thailand. Materials and Methods: Thirty patients with canalicular laceration were treated between January 2005 and December 2017. Data gathered from ICD10, operation records, and in-patient and out-patient medical records were retrospectively analyzed. Results: There were 20 males (66%) and 10 females (34%) with a mean age of 30.86 years (range 1 to 78 years). Seventy percent of patients presented outside of normal office hours. Most injuries were caused by non-vehicular accidents. Twentyfive of 30 cases (83.33%) were repaired by trainees, and 63% of cases were repaired after office hours. The mean waiting time from presentation to repair was 9 hours 56 minutes (range: 3 hours 35 minutes to 22 hours 10 minutes). The follow-up rate at six months postoperative was 53.33%. The success rate of repairs performed by trainees was 93.75%. Conclusion: The success rate of lacrimal canalicular laceration repair performed by trainees was very satisfactory. The average waiting time for surgery was acceptable. Only half of the patients were followed-up for six months post-operative. Improvement is required in the recording of pertinent details in the medical records, which is an important issue to train the trainees. Keywords: Tear canaliculus, Lacrimal canalicular laceration, Repair, Residents, Trainees, Oculoplastic surgeon

The efficacy of minimally invasive repair for laceration of inferior lacrimal canaliculus

Objective To evaluate the clinical efficacy of minimally invasive repair and anastomosis of inferior lacrimal canaliculus laceration. Methods The data of 83 eyes of 83 patients with inferior lacrimal canaliculus laceration in this hospital from Dec. 2015 to Apr. 2018 were retrospectively analyzed. The study included 29 cases in the observation group and 54 cases in the control group. All cases performed surgery under the operating microscope, and the broken end of the nasal side were directly probed along the wound edge during operation. The control group adopted the ordinary anastomosis method of dual anterograde intubation with silicone stent. The observation group adopted minimally invasive anastomosis method. The lacrimal duct stent was placed into the lacrimal duct to anastomose the inferior lacrimal canaliculus laceration. All cases were followed up for 6 months. Results The operation time of the observation group was significantly shorter than that of the control group, and the difference was statistically significant (P=0.000). There was no significant difference in the recovery rate between the two groups (P=0.807). The incidence rate of puncta slitting in the observation group were significantly lower than that in the control group (P=0.046). Conclusion The minimally invasive repair for inferior lacrimal canaliculus rupture does not cause secondary injury, and the efficacy is definite. Key words: Laceration, lacrimal canaliculus; Repair, minimally invasive; Efficacy

Apart From Surgical Procedures, Another Important Point to Note in Lacrimal Canalicular Lacerations: Traumatic Retinal Tears.

To evaluate fundus examinations in terms of traumatic retinal tears or dialysis that may be related to canalicular lacerations (CLs). This retrospective study was conducted on patients with CL repair from June 1, 2009 to May 30, 2018. The authors collected the data from the patients' medical records, including their demographic details, mechanism and setting of injury, associated ocular injuries, type of stent used, setting of repairs, duration of follow-up, complications, pre- or intraoperative findings of biomicroscopic and fundus examinations, refractive errors, postoperative follow-up of fundus examination, and management. Sixty patients (43 males and 17 females) were included in the study. The mean age of all the patients was 27.50 ± 21.72 (min: 1-max: 94) years. Isolated CL was found in 38 patients. Nonisolated CL, which means with some additional pathologies, were found in 22 patients (37%, approximately 1/3). Retinal follow-up records were available in 49 patients with a mean follow-up period of 7.48 ± 9.82 months. Retinal tears were seen in 3 patients (0.05%) with no predisposing risk factors. Two of these tears were found in the follow-up period after the traumas. Consequent retinal tears after canalicular lacerations were not strongly addressed in previous works. In this study, the authors aimed to view CL from a different perspective. Canalicular laceration is also an ocular trauma that may threaten vision. The authors emphasized that performing detailed fundus examinations and follow-up in all canalicular traumas is necessary.

Efficacy of application of newly designed silicone stent in the anastomosis of lacrimal canaliculus

Objective To evaluate the efficacy of application of newly designed silicone stent in the anastomosis of inferior lacrimal canaliculus. Methods The data of 45 eyes of 45 patients with inferior lacrimal canaliculus laceration from Mar. 2016 to Mar. 2018 were analgzed retrospectively. The newly designed silicone tube was implanted in the anastomosis of lacrimal canaliculus, and the broken end of the lower lacrimal canaliculus were sutured with 8-0 absorbable suture. Then the lacrimal stents were removed at 3 months after operation. The patients were followed up for 6-12 months. Results After operation, 41 patients(91.11%) were cured, 2 patients(4.44%) were improved. However, 2 patients were ineffective. The total effective rate was 95.56%. The main complications were lacrimal duct obstruction in 2 patients (4.44%) and lacrimal point tear in 1 patient (2.22%). Conclusion The newly designed silicone stent has the characteristics of simple to operate, excellent cosmetic result, safe state of catheterization and convenient to fetch tube. Key words: Anastomosis, lacrimal canaliculus; Stent, silicone, newly designed

Efficacy of bicanalicular stents intubation for traumatic lower lacrimal canalicular laceration

Objective To evaluate the efficacy of bicanalicular stents intubation for the treatment of traumatic lower lacrimal canalicular laceration. Methods The clinical data of 33 eyes of 33 cases with lower lacrimal canalicular laceration from Jan. 2017 to Feb. 2018 were collected and analyzed retrospectively. The proximal end of the canalicular lacerations was found under microscope. Bicanalicular stents intubation was performed during operation.The lacrimal stent was removed 3 months after surgery. The follow-up time was 6 months. Results The lacrimal canaliculus segment of all cases were found successfully under operating microscope.Thirty-one cases (93.9%) were cured, 2 cases (6.1%) were effective. Conclusion Bicanalicular stents intubation for the treatment of traumatic lower lacrimal canalicular laceration is effective and safe. Key words: Lacrimal canalicular laceration, lower, traumatic; Stents, bicanalicular, intubation; Lacrimal canalicular anastomosis

Application of LY-Fr3 lacrimal duct stent in anastomosis of lacrimal canaliculus

Objective To analyze the efficacy of application of LY-Fr3 lacrimal duct stent in anastomosis of lacrimal canaliculus. Methods The data of 90 eyes of 90 patients with laceration of lacrimal canaliculus laceration were analyzed retrospectively, and all patients were treated with anastomosis and intubation of LY-Fr3 lacrimal duct stent. The follow up time was 6 months. Results The surgery time was 40 - 90 min, with average of (60.0±15.4) min. The curative rate was 90.0%, the effective rate was 96.7%. There were 14 patients (15.6%) with complications, included 11 cases of second blocking, 4 cases of anastomotic swollen, 2 cases of laceration of lacrimal punctum and 1 case of secondary dacryocystitis. The second blocking rate of patients removed the stent 3 months after surgery (32.4%) was higher than that 6 months after surgery (11.3%, P 0.05). Conclusion The appliction of LY-Fr3 lacrimal duct stent could get good effect in anastomosis of lacrimal canaliculus. Key words: Stent, duct, lacrimal, LY-Fr3; Anastomosis, laceration, lacrimal canaliculus; Complication

Comparison on the efficacy between two kinds of stent in the anastomosis of lacrimal canaliculus

Objective To compare the application efficacy between RS-type lacrimal intubation and tear duct drainage stent in the anastomosis of lacerated lacrimal canaliculus. Methods The data of 78 eyes of 78 cases with lacrimal canalicular laceration were collected.All cases were randomly divided into 2 groups. Group A, 38 cases were treated with RS-type lacrimal stent and 40 cases were treated with drainage stent in group B. All patients were removed the stent 3 months after surgery. The differences of operative time, intraoperative comfort, efficacy and the rate of complications between the two groups were compared. Results The operation time of group A was (61.71±8.79) min, and group B was (68.25±7.56) min. The difference was statistically significant (t=3.527, P=0.001). The intraoperative pain score of group A was 3.58±0.83 and 4.20±0.97 of group B (t=3.044, P=0.003). The total rate of complications was 20.0% in group B and 15.8% in group A (χ2=0.235, P=0.656). The postoperative evaluation was made when removed the stent 3 months after operation. The total effective rate of group A was 92.1%, while that of group B was 90.0%(χ2=0.106, P=0.752). Conclusion Applications of two stent in surgery are effective, which are ideal supporting materials. However, RS-type lacrimal stent is superior to lacrimal duct drainage stent with short operation time and good intraoperative comfort. Key words: Laceration, canalicular; Stent, lacrimal, RS-type, tear duct drainage stent; Efficacy

Analysis of the operation timing and effect of anastomosis for 388 cases of laceration of inferior lacrimal canaliculus

Objective To investigate the surgical timing of anastomosis and efficacy of U-type silicone stent implantation for the treatment of laceration of inferior lacrimal canaliculus. Methods From Jan. 2012 to Oct. 2016, the data of 388 eyes of 388 patients with laceration of inferior lacrimal canaliculus were analyzed retrospectively. Age of all cases ranged from 2 to 79 years. There were 314 males (80.9%) and 74 females. All cases underwent double lacrimal canaliculus placement silicone stent implantation under the surgical microscope. The silicone stent was placed for 3 months and followed up for 3 months after removed. Results The difference of efficacy was not statistically significant among different operation time. At the end of follow-up, the cure rate was 78.3%, the recovery of rate was 13.6%, and the inefficiency was 8.1%. Conclusion The surgical timing of anastomosis for lacrimal canaliculus laceration should be choose before the anterior eyelid tissue edema, and it is easier to find the nasal breakage of lacrimal duct. Key words: Laceration, inferior lacrimal canaliculus; Anastomosis; Surgical timing; Stent, silicone, double lacrimal canaliculus placement

Observation on the efficacy of double ring guided anterograde intubation for the treatment of traumatic lacrimal canaliculus laceration

Objective To observe the efficacy of double ring guided anterograde intubation for the treatment of traumatic lacrimal canaliculus laceration. Methods The data of 165 eyes of 165 cases with traumatic canaliculus laceration from Jan. 2015 to Dec. 2016 were analyzed retrospectively. All patients underwent double ring guided anterograde intubation for canalicular reconstruction. The tubes were removed at 3-6 months postoperatively, average(20.6±5.2) weeks. Results Of 165 cases, 140 cases (84.85%) were cured, 23 cases (13.94%) were improved, and 2 cases (1.21%)invalid. No significant complication occurred after operation. Conclusion Double ring guided anterograde intubation is safe and effective to reconstruct canaliculi anatomically and functionally. Key words: Lacramal intubation, double ring, anterograde; Laceration, canaliculus

The clinical efficacy of double stent method with silicone tubes for the treatment of lacrimal canaliculus laceration

Objective To investigate the efficacy of double stent intubation with silicone tubes for the treatment of lacrimal canaliculus laceration. Methods The lacrimal canaliculus rupture ends was found under the surgical microscope by the methods of direct search, gas injection, water injection and the probe guiding. All cases received the silicone stent into the nasolacrimal duct through the double path. The anastomosis lacrimal canaliculus ends were sew up reduced tension. Results Twenty-six eyes of 26 cases with lacrimal canaliculus laceration underwent the surgery. The symptom of epiphora disappeared and lacrimal irrigation unobstructed in 23 cases. Two cases occurred narrow lacrimal when it was irrigated in 1 week after extubation, with mild epiphora. The symptom of epiphora, and obstructed lacrimal irrigation happened in 1 case. Twenty-three cases (88.46%) were cured completely, 2 cases (7.69%) were improved, 1 case was invalid (3.85%). Conclusion The surgery of double canalicular stent method with silicone tube for the lacrimal canaliculus laceration is simple and little damage. Key words: Silicone stent; Double catheter method; Lacrimal canaliculus laceration

The complication and preventative methods in anastomosis of lacrimal canaliculus laceration

Objective To investigate the complication and preventative methods in anastomosis of lacrimal canaliculus laceration. Methods The types and the cause of the complication afier lacrimal canaliculus laceration anastomosis on 14 eyes of 14 cases were analyzed.The technical improvement of the surgery was discussed for preventing the complication. Results The anastomotic rupture, stent dislodgement, lacrimal ductule rupture, lower eyelid ectropin were the major complications after lacrimal ductule laceration anastomosis.Inexactly contrapuntal suture and intraoperative epidural catheter fixed firmly were the main cause of complications. Conclusion Finding the broken end and accurate anastomosis is the key points to repair lacrimal canaliculus laceration.Epidural catheter firmly fixed and strengthen follow-up are important measures for reducing complications. Key words: Laceration, lacrimal camaliulus; Anastomosis; Complication; Improvement, technical

Is the distance from punctum a factor in the anatomical and functional success of canalicular laceration repairs?

Purpose:The aim is to analyze the influence of the location of lacrimal canalicular laceration over the eventual anatomical and functional success after surgery.Methods:Retrospective, observational study of proximal canalicular laceration (PCL) and distal canalicular laceration (DCL) repairs by a single surgeon (MS). The distance between lacrimal punctum and the lateral canalicular lacerated end was defined as proximal (<6 mm) and distal (≥6 mm). The operation theater setup, microscopic magnified view, local adrenaline, and pigtail probe were used to locate the medial canalicular lacerated end. All patients underwent lacrimal stenting and the stents were removed after 3 months (12th week visit). After stent removal, a fluorescein dye disappearance test and lacrimal irrigation were performed to assess the anatomical and functional success of the operation.Results:Of 36 canalicular lacerations, 30 (83.33%) were monocanalicular lacerations which were repaired using monocanalicular stents. Of 6 (16.67%) bicanalicular lacerations, three were repaired using bicanalicular stents while in the remaining three, one monocanalicular stent was placed in each lacerated canaliculi. The medial cut end was identified by magnified visualization in 27 (75%), with adjunctive local adrenaline in four (11.11%) and pigtail probe in five (13.89%) patients. The mean post stent removal follow-up was 44 weeks. The DCL (n = 24, 66.67%) showed better functional and complete success as compared to PCL (75% vs. 33.33%, P = 0.03). Eight (22.22%) had spontaneous stent extrusion, two (5.56%) had loop prolapse, four (11.11%) had punctum granuloma, and three (8.33%) had medial canthus dystopia.Conclusion:The location of canalicular laceration may help to prognosticate the functional and qualified success rate. We experienced better-qualified success in the distal canalicular laceration group.

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

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

The analysis of 54 cases of anastomasis for traumatic lacrimal canaliculus lacerations

Objective To investigate the effective methods of anastomosis for traumatic lacrimal canaliculus lacerations. Methods The appropriate surgical methods of broken ends finding and anastomosis were performed in 54 eyes of 54 cases with traumatic lacrimal canaliculus lacerations according to their specific injuries. Results Of 54 eyes after treatment 4 cases of 48 eyes with inferior lacrimal canaliculus laceration were obstructed in early time postoperatively, 4 cases obstructed 6 months later. One case of 3 patients with superior lacrimal canaliculus laceration appeared epiphora. 3 cases with both superior and inferior laceration of lacrimal canaliculus flushed smoothly when the pipes were put out. Conclusion Appropriate surgical method according to injury condition is effective for traumatic lacrimal canaliculus laceration. Key words: Lacrimal canalicular, lacerations, traumatic; Anastomosis

Retrograde intubation for inferior lacrimal canaliculus laceration

Objective To investigate the clinical effect of lacrimal duct retrograde intubation for traumatic inferior lacrimal canaliculus laceration. Methods Forty-five eyes of forty-five cases with inferior lacrimal canaliculus laceration were retrospectively analysed. The operation was performed under operating microscope. The probing needle of lacrimal passage was inserted from the nasal broken end,Ytype nasolacrimal stent with lacrimal canaliculus was implanted retrogradely and lacrimal canaliculus was anastomosed. Results Canalicular nasal ends of all the 45 patients could be successfully found under microscope and be anastomozed. No stent slippage or formation of granulation occurred, 43 cases were cured, and lacrimal canaliculus was obstructed again in 2 cases after extubation. Conclusion Retrograde intubation for traumatic inferior lacrimal canaliculus laceration has high success rate, less injury, and less pain. Key words: Lacrimal disease; Laceration, lacrimal canaliculus; Anastomosis, lacrimal canalicular; Intubation, lacrimal duct, retrograde

Reconstructions of Traumatic Lacrimal Canalicular Lacerations: A 5 Years Experience

Background: The aim of this study is to evaluate the demographic and epidemiological data, clinical features and surgical outcomes of lacrimal canalicular lacerations. Methods: The charts ofall patients who applied to our emergency department with eyelid laceration from 2008 to 2013 were reviewed retrospectively. Demographic and epidemiological data, clinical characteristics, treatment outcomes, simultaneous injuries and complications of patients who underwent canalicular laceration repair surgery were analyzed. Results: A total of 556 patients were identified with an eyelid laceration, and in 42 (7.55%) of these patients 44 lacrimal canalicular lacerations were detected. The average age was 26.16±18.42 (range 5 to 78) years and mean follow-up time was 17.62±6.62 months (range 12-42 months). The male-to-female ratio was 5.3-1. The lower canaliculus was involved in 33 patients (78.57%), the upper in 7 patients (16.6%), and 2 patients (4.76%) had bicanalicular involvement. The most common etiology of canalicular laceration was assault (n = 16, 38.1%) followed by traffic accidents (n = 8, 19.05%). In 28 patients (66.67%) surgery was performed within 24 hours and in 14 patients (33.33%) surgery was performed between 24 hours and 6 days. In 32 patients (76.2%) direct anatomosis and in 10 patients (23.8%) indirect anastomosis was performed. Tubes were removed after a mean time of 5.8±2.8 months. Anatomic success was 96.87%, while functional success was 92.85%. Complications were detected in 3 cases: two patients had early tube extrusions and in patient had punctal slits. Conclusion: Reconstruction of traumatic lacrimal canalicular lacerations with stenting gives good results at long-term follow up. The Mini-Monoka tube is a safe, simple, effective method with few complications.