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Long-term outcomes of a new anatomy-based method for finding the medial cut end during late canalicular repair

  • Author Footnotes
    † Yimin Li and Yefei Wang contributed equally to the article.
    Yimin Li
    Footnotes
    † Yimin Li and Yefei Wang contributed equally to the article.
    Affiliations
    Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China

    Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
    Search for articles by this author
  • Author Footnotes
    † Yimin Li and Yefei Wang contributed equally to the article.
    Yefei Wang
    Footnotes
    † Yimin Li and Yefei Wang contributed equally to the article.
    Affiliations
    Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China

    Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
    Search for articles by this author
  • Lunhao Li
    Affiliations
    Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
    Search for articles by this author
  • Caiwen Xiao
    Affiliations
    Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
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  • Xiaoping Bi
    Affiliations
    Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
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  • Author Footnotes
    # These authors share senior authorship.
    Huifang Chen
    Correspondence
    Corresponding authors: Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, China.
    Footnotes
    # These authors share senior authorship.
    Affiliations
    Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China

    Nursing Department, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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  • Author Footnotes
    # These authors share senior authorship.
    Wodong Shi
    Correspondence
    Corresponding authors: Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, China.
    Footnotes
    # These authors share senior authorship.
    Affiliations
    Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China

    Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
    Search for articles by this author
  • Author Footnotes
    † Yimin Li and Yefei Wang contributed equally to the article.
    # These authors share senior authorship.
Published:October 14, 2022DOI:https://doi.org/10.1016/j.bjps.2022.10.005

      Abstact

      Background

      Locating the medial cut end during late repair of canalicular lacerations can be challenging.

      Objective

      The aim of this study was to evaluate the effectiveness and long-term outcomes of a new anatomy-based method for solving the problem of locating the medial cut end.

      Methods

      This retrospective interventional study included 85 eyes of 85 consecutive adult patients with unilateral inferior canalicular lacerations who underwent late primary (≥2 days after injury) or secondary (≥6 months after initial treatment) surgery. Before surgery, the lacerations were classified as lateral, central, or medial according to the ‘distance from the punctum to the distal end’ of the lacerated inferior canaliculus. The time spent to locate the proximal lacerated end (TSL) was recorded. All patients were followed up for ≥1 year to evaluate the lacrimal passage patency and the distance between the superior and inferior punctum (DBSIP, to assess cosmesis).

      Results

      There were 16 (18.82%) lateral-type, 55 (64.71%) central-type, and 14 (16.47%) medial-type canalicular lacerations. The TSL was 3.48 ± 1.05 (range 0.9–6.8) min for all patients and differed significantly among the three types of canalicular lacerations (P < 0.001). Lacrimal irrigation showed patent lacrimal passages in 69 patients (81.18%) at 3 months and a further 4 patients (4.71%) at 6 months, residual stenosis without obstruction in 5 patients (5.88%), and obstruction in 7 patients (8.24%). The postoperative DBSIP on the affected side was shorter than the preoperative DBSIP (2.66 ± 0.66 vs. 3.09 ± 1.72 mm, P = 0.006) and comparable to that on the unaffected side (2.78 ± 0.40 mm).

      Conclusion

      Our new anatomy-based method is efficient and achieves good long-term outcomes for all types of late canalicular repair.

      Keywords

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