A Simple New Method for Identifying the Proximal Cut End in Lower Canalicular Laceration

Abstract

PurposeWe report a simple and effective method of identifying the medial cut end of lower canalicular laceration cases.MethodsTwenty-seven eyes with lower canalicular lacerations as a result of trauma were involved in the study. Surgery was performed within 48 hours after injury for canalicular reconstruction. Upper canalicular probing was utilized to identify the medial cut end of deep canalicular lacerations when difficulties were encountered. Total time from the initiation of the probing procedure to the identification of the medial cut end of the lower canaliculus was measured.ResultsA total of 27 eyes with lower canalicular lacerations were reconstructed. In 20 eyes, the medial lacerated end was located by upper canalicular probing. The mean time from initiation of the probing procedure to identification of the medial cut end of the lacerated canaliculus was 2 minutes.ConclusionsWe conclude that upper canalicular probing in patients with lower canalicular lacerations significantly reduces the time from the initiation of the operation to the identification of the medial cut end of the lower canaliculus.

A modified bicanalicular intubation procedure to repair canalicular lacerations using silicone tubes

“…On the basis of the canalicular anatomy and microscopic magnification, locating the damaged end of the canaliculi has become simpler. 1 To ensure the normal function of the injured canaliculi after healing, the placement of a silicone tube in the canalicular system has been recommended as a surgical stent during the healing process. 2 The temporary stent intubation could prevent canalicular obstruction during recovery.…”

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

“…Silicone intubation was most commonly used in surgery because of its advantage of restoring a normal anatomical pathway to avoid false path [5]. With double-passage canalicular intubation, circular stents using silicone tubes provide good stabilization, and keep the natural location of the medial canthus, maintain the physiological anatomical reposition of the superior and inferior punctum, which prevents the ectropion and laceration of the lower eyelid and inferior punctum, and offer excellent tear drainage [5,6,7]. However, it is reported that the disadvantages of double-passage canalicular intubation include the irritation symptoms and additional secretion [22].…”

“…The canalicular anastomosis combined with bicanalicular or monocanalicular stent intubation is used for primary canalicular laceration repair [5]. A variety of materials have been used to stent the torn canaliculus clinically, such as the medical-grade silicone stent [6,7], like the Freda ® silicone tube, the mini-Monoka ® [8], the Masterka ® [9]. The mini-Monoka ® is one of the monocanalicular stents, comprised of a silicon rod with a bulb and collar at the proximal end, which makes it self-retaining [8].…”

“…Mini-Monoka ® insertion is suitable for conditions, such as canalicular laceration involving external two-thirds of canaliculus without damaging the canthal ligament. 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].…”

Innovative cost-effective method to repair lacrimal cannaliculi laceration – finding proximal end and stent

“…Many authors have suggested the use of pig tail to detect the proximal end [4], [5], [6], [7], [8]. A similar mechanism is used in the current technique but in a more cost-effective way.…”