Canalicular lacerations: Factors predicting outcome at a tertiary eye care centre

Abstract

To determine the factors predictive of outcome in canalicular laceration repair at a tertiary eye care centre. A retrospective review of the medical records of all primary canalicular laceration repairs managed at a tertiary eye care centre between the years 2006 and 2014 was done. Thirty-nine patients were included and majority were male (79.5%) with a mean age of 30.05 + 16.2 years (range 2-65). Most (n = 34) had monocanalicular laceration and 5 had bicanalicular laceration. All surgeries were done in the operating room setting. Overall patency by irrigation was seen in 74.4% at a median follow-up of 19.89 weeks (range 21-910). Anatomical outcome was different among the stents and best after Mini-Monoka monocanalicular stent (17/19; 89.5%) followed by bicanalicular annular stents (n = 6; 60%) and 20G Silicone rod (8/14, 57%). The factors predictive of poor outcome were related to the mode of injury [road traffic accidents; Hazard ratio (HR)19.57; p = 0.048] and the type of stent [20G silicone rod (HR 35.7; C.I 3.04 - 419.14; p = 0.004)] by multivariate analysis. Skill of the surgeon was critical as the outcome for fellows-in-training showed a trend towards failure (HR 6.66, p = 0.07). Complications included stent extrusion (n = 28.2%), punctal granuloma (n = 5.1%) and stent exposure (n = 2.5%). The mode of injury - road traffic accidents and type of stent - 20 G silicone rod were risk factors predictive of poorer outcome after canalicular laceration repair. Individual skill of operating surgeon may be a critical factor suggesting a review of training protocols.

Novel Application of Vasofix Cannula for Punctal and Canalicular Laceration

“…Similar age group was observed in the present case study compared to previous study managed with monoka monocanalicular stent that showed 92% success rate with two tube protrusion, two punctual slits and one punctual ranuloma [5]. In a retrospective analysis of 39 patients, complications were stent extrusion, puctal granuloma and stent exposure [6].…”

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

“…Silicone intubation is most commonly used in surgery because of its advantageous attributes, namely, inert nature, exibility, and easy availability [6,7]. Several factors impact the effectiveness of laceration repair, including the extent and location of canalicular lacerations, the intubation materials, the duration of intubation, and the surgical technique [10,11,12]. The present study was conducted to review the cases of 142 patients with primary canalicular lacerations in the Department of Ophthalmology of Shanghai Ninth People's Hospital, China.…”

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

“…The silicone intubation is most commonly used in surgery based on its advantage of an inert nature, flexibility, and easy availability [6,7]. Several factors impacting the effectiveness of laceration repair include the extent and location of canalicular laceration, intubation materials, duration of intubation, and surgical technique [10,11,12]. The present study was conducted to review 142 patients with primary canalicular laceration in the department of Ophthalmology, Shanghai Ninth People's Hospital, China.…”