Mini Monoka silicone monocanalicular lacrimal stents: Subjective and objective outcomes

Abstract

BACKGROUND. Canalicular injuries and anomalies are relatively common. Despite this, controversy still exists regarding the indications for surgery and best surgical methods. The most favourable intervention would be one that is simple, associated with a high level of subjective and objective outcome, and does not threaten the uninjured or unaffected part of the lacrimal drainage system. This study assesses outcomes of intervention with the Mini Monoka silicone monocanalicular lacrimal stent. METHOD. A single cohort, hospital-based study with retrospective and prospective components. Participants were all identifiable patients at Bristol Eye Hospital in whom the Mini Monoka silicone monocanalicular stent was used for any indication. Retrospective analysis of patient records for all related pre-operative, operative and postoperative data was performed. Prospective analysis of subjective outcome via confidential patient questionnaire and objective outcome via clinical examination was performed. RESULTS. Complete data were obtainable in 13 patients (14 canaliculi) of the identified 22 patients (23 canaliculi). Follow-up was from 12 to 70 months (mean 39 months). A high level of subjective outcome was noted with no patients experiencing significant or disabling symptoms. In terms of objective outcome, 79% achieved canalicular patency. The main complications with this technique were premature stent loss (29%) and stent migration (14%). CONCLUSIONS. The Mini Monoka monocanalicular stent is a safe, effective and simple surgical technique that, unlike bicanalicular procedures, does not threaten the uninjured / unaffected part of the lacrimal drainage system.

Microsurgical Reconstruction for Canalicular Laceration Using Monostent® and Mini-Monoka®

“…3,22 The Mini-Monoka (FCI Ophthalmics, Marshfield Hills, MA) and Monostent (Eagle Vision Inc., Memphis, TN) stents were developed to prevent the various complications of silicone monocanalicular stents. Anastas et al 8 ) from the inferior punctum, its distal portion was unexpectedly found to be distorted. Note that the Monostent (Eagle Vision Inc.) has a larger inner diameter, which allows a 23-gauge needle to be passed through the plug.…”

“…Furthermore, silicone tubing has achieved great popularity due to its softness, flexibility, and tolerance by pericanalicular tissues. 8 Although some studies have recommended limiting silicone stent placement for 3 to 9 months, because it might act as a nidus for granuloma formation and infection, 32,33 we leave stents in situ for as long as possible, even permanently, if the patient has no complaint of epiphora.…”

Evaluation of the anatomical and functional outcomes in patients undergoing repair of traumatic canalicular laceration

“…[15] Success rate of monocanalicular intubation method has been reported in the range of 60% to 100%. [21][22][23]30,32,33] High rate of success has also been described in some studies conducted in our country. Argın et al, [12] Yaman et al, [29] and Oltulu et al reported success rate of 100%.…”

“…[21] However, in 19-patient series of Leibovitch et al, early tube dislocation was not observed in any patient. [22] Risk of early tube dislocation can increase, especially in children, due to rubbing and scratching.…”

Reconstructions of Traumatic Lacrimal Canalicular Lacerations: A 5 Years Experience

“…Premature stent extrusion and stent migration are the major disadvantages of this technique and can result in a poor surgical outcome. Anastas et al reported premature extrusion in 29% and stent migration in 14% of 13 cases [12]. Over-dilation of the punctum is a risk factor for stent migration [13].…”