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

Abstract

Background: 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 bicanalicular stent in central China. It aims to provide a reference for clinical work.Methods: 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 30 th 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. Results: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 bikeassociated 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 89.86%.Conclusions: 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.

Acute and Past Common Lacrimal Canalicular Lacerations: A Report of Two Cases

“…Several treatment methods have been reported for monocanalicular and bicanalicular lacerations [1,[11][12][13]. The cut-off site was determined using a pigtail probe, a light guide, or by filling the lacrimal sac with viscoelastic material or air.…”

“…Lacrimal canalicular lacerations can be caused by trauma to the ocular adnexa, such as a penetrating or blunt injury. Canalicular disruption complicates 16-37% of routine eyelid lacerations [1][2][3]. Canalicular anastomosis combined with stent intubation has been used to repair canalicular lacerations.…”

Repair of an Inferior Canalicular Laceration using a Flexible Mono-Canalicular Probe with Self-Stabilizing Meatic Fixation

“…In these cases, a complete monocanaliculo-nasal intubation (MCNI), or a bicanaliculo-nasal intubation (BCNI) is performed.  Wounds of the external 2/3: the most common [2][3][4][5][6], where vertical intubation is not essential. In these cases, we perform a true mono-canalicular intubation (IMC) as for our patient.…”

“…Various materials have been used to stent the torn canaliculus in the past. Medical grade silicone, due to its inert nature and flexibility, has become the material of choice for tear stenting [2][3].…”

Canalicular lacerations: Techniques used and timing to intervene

“…However, there are limited data available comparing the incidence rates among different regions. [ 2 ]…”