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
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Plastic, Reconstructive & Aesthetic SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Eyelid injuries: epidemiological aspects.Der Ophthalmol. 2001; 98: 1079-1082
- Lacrimal traumatology.J Fr Ophtalmol. 2016; 39: 213-218
- Clinical characteristics, intraoperative findings, and surgical outcomes of canalicular laceration repair with monocanalicular stent in Asia.J Ophthalmol. 2019; 20195872485
- Canalicular laceration repair: an analysis of variables affecting success.Ophthal Plast Reconstr Surg. 2014; 30: 410-414
- Old canalicular laceration repair: a retrospective study of the curative effects and prognostic factors.Int J Ophthalmol. 2017; 10: 902-907
- Canalicular laceration. An 11-year epidemiologic and clinical study.Ophthal Plast Reconstr Surg. 1990; 6: 46-53
- Management of canalicular laceration.Surv Ophthalmol. 1991; 36: 113-132
- Symptoms of canalicular obstruction.Ophthalmology. 1988; 95: 1077-1079
- Outcome after repair of concurrent upper and lower canalicular lacerations.Orbit. 2014; 33: 169-172
- Traumatic Canalicular Laceration Repair with a New Monocanalicular Silicone Tube.Ophthal Plast Reconstr Surg. 2017; 33: 27-30
- Novel air-injection technique to locate the medial cut end of lacerated canaliculus.Br J Ophthalmol. 2013; 97: 1508-1509
- A simple new method for identifying the proximal cut end in lower canalicular laceration.Korean J Ophthalmol. 2008; 22: 73-76
- Management of canalicular lacerations: epidemiological aspects and experience with Mini-Monoka monocanalicular stent.Am J Ophthalmol. 2008; 145: 375-380
- Long-term outcomes of monocanalicular repair of canalicular lacerations.Ophthalmology. 2014; 121 (1665-6.e1)
- Early versus late canalicular laceration repair outcomes.Am J Ophthalmol. 2017; 182: 155-159
- The round-tipped, eyed pigtail probe for canalicular intubation: a review of 228 patients.Ophthal Plast Reconstr Surg. 2008; 24: 176-180
- The bubble test: an atraumatic method for canalicular laceration repair.Ophthal Plast Reconstr Surg. 1996; 12: 61-64
- A new method for identifying the cut ends in canalicular laceration.Sci Rep. 2017; 7 (43325-)
- Analysis of bicanalicular nasal intubation in the repair of canalicular lacerations.Jpn J Ophthalmol. 2010; 54: 24-31
- Two-step retrograde closed stenting: a novel method for treating canalicular lacerations in Chinese patients.Eye. 2013; 27: 1275-1280
- Incidence of postoperative obstruction at different sites of lacrimal canalicular injury.Plast Reconstr Surg. 2012; 129 (731e-3e)
- A new method for locating the proximal lacerated bicanalicular ends in Chinese preschoolers and long-term outcomes after surgical repair.Medicine (Baltimore). 2017; 96 (e7814-e)
- Is the distance from punctum a factor in the anatomical and functional success of canalicular laceration repairs?.Indian J Ophthalmol. 2017; 65: 1114-1119
- Retrograde intubation dacryocystorhinostomy for proximal and midcanalicular obstruction.Ophthalmology. 1999; 106 (discussion 8-9): 2325-2328
- Surgical anatomy of the lower eyelid relating to lower blepharoplasty.Anat Cell Biol. 2010; 43: 15-24
- Management of canalicular lacerations: epidemiological aspects and experience with Mini-Monoka monocanalicular stent.Am J Ophthalmol. 2008; 145: 375-380
- Canalicular laceration repair using a self-retaining, bicanalicular, hydrophilic nasolacrimal stent.Orbit. 2021; 40: 239-242
- Overview of the lacrimal canaliculus in microscopic cross-section.Orbit. 2007; 26: 237-239
Article info
Publication history
Published online: October 14, 2022
Accepted:
October 4,
2022
Received:
January 17,
2022
Identification
Copyright
© 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
