Canalicular lacerations in a tertiary eye  hospital: our experience with monocanalicular stents

Raj, Amit; Thakur, Sahil; Arya, Kumar Sudesh; Kesarwani, Prem; Sinha, Upasna

doi:10.22336/rjo.2020.26

Cited by 6 publications

(7 citation statements)

References 20 publications

(33 reference statements)

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“…This modified bicanalicular intubation method has recently been proven to be an effective, atraumatic procedure for managing canalicular lacerations with fewer complications compared to the traditional procedure. 12 In patients with combined upper and lower canalicular lacerations, as was the case in this patient, the Crawford stent is the preferred type of bicanalicular stent that can be appropriately utilized for the intervention. In a previous study, the MBCI was found to be an effective technique with an anatomical success rate of 97.14%.…”

Section: Discussionmentioning

confidence: 70%

Multiple Approaches for Managing Complex Ophthalmic Blunt Trauma: A Case Report

Irawati

Soedarman²,

Arianti³

et al. 2021

IMCRJ

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Introduction: Ophthalmic trauma is defined as injuries affecting the ocular structures, including the globe, eyelid, lacrimal system, and surrounding orbital walls. Blunt trauma acts as the leading cause of injury and it may affect both the anterior and posterior parts of the globe. Prompt diagnosis, early management, and sustained follow-up are mandatory for an optimal outcome. Purpose: This report presents a one-step surgery management process for an intricate case of blunt facial trauma with complex ophthalmic and nasal injury. Patients and Methods: A 45-year-old male with blunt force trauma of the left eye from a wooden block, suffered from naso-orbital-ethmoidal fractures, eyelid laceration with canalicular, close-globe injuries of traumatic cataract and vitreous hemorrhage with retinal detachment. A simultaneous one-step surgery was performed by a trauma team of ophthalmological and ENT surgeons during the height of the COVID-19 pandemic to lessen the risk of cross-transmission. After ruling out the possibility of open-globe rupture, traumatic cataract extraction, retinal detachment surgery, the repair of an eyelid laceration with canalicular involvement, and septorhinoplasty were performed on concomitantly. Results: Anatomical success was achieved for the repair of the nasoorbitoethmoidal (NOE) type II fracture and close-globe injuries, including the anatomical reattachment of the retina. However, the functional outcome remained unsatisfactory. Visual acuity failed to show further improvement at a later follow-up. Traumatic optic neuropathy was, at the final follow-up, considered to be the cause of the suboptimal visual acuity. Conclusion:A single-step multi-procedure for a complex ophthalmic blunt trauma, as demonstrated in this case, may be beneficial for reducing the complications that might arise due to treatment delay. The complex nature of the injury, however, creates the higher possibility for residual post-operative complications. Risks of residual functional impairment should be considered in such complex trauma prior to surgery, to determine the surgical prognostic value and provide appropriate consent to the patient.

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Section: Discussionmentioning

confidence: 70%

Multiple Approaches for Managing Complex Ophthalmic Blunt Trauma: A Case Report

Irawati

Soedarman²,

Arianti³

et al. 2021

IMCRJ

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“…19 Raj et al, concluded that time of surgical intervention is an important predictor of final surgical success. 20 In our study, there was one patient in whom anatomical and functional success could not be achieved and we could not ascertain whether the cause was delayed repair or the deep nasal cut end and further studies are needed to assess the association of delayed repair and final outcome.…”

Section: Discussionmentioning

confidence: 84%

Surgical outcomes of canalicular tear repair with self-retaining Mini-Monoka stent in a tertiary care hospital in Kashmir in North India

Hakak

Wani

2022

Asian J Med Sci

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Background: Canalicular lacerations contribute to approximately 16% of the eye lid injuries. The torn medial end is to be identified, cut end sutured, and then the canaliculus intubated to restore patency. Silicone being inert, flexible, easily available, and cost effective is the material of choice for lacrimal stenting. Aims and Objectives: The aim of this study was to determine the surgical outcomes of the canalicular tear repair with the self-retaining Mini-Monoka stent in a tertiary care hospital in North India. Materials and Methods: Patients presenting to tertiary care hospital in Kashmir, North India with canalicular tear from August 2019 to December 2020 were included in this prospective study and repaired with self-retaining Mini-Monoka stent under microscope. All the patients were analyzed for demographic data, mode of injury, complications, and outcomes and followed up after a week, 6 weeks, and 3 months and stent removed after 6 weeks. Results: The study was conducted on 18 patients. The mean age of the patients was 37.5 years with male: female ratio of 5:1. The lower canaliculus was most commonly involved and road traffic accidents was the most common mode of injury (27.7%). The most common associated injury was lid injury (50%). The mean time of stent removal was 6 weeks±2 weeks. Syringing was done in all the patients except children. At last follow-up, 17 out of 18 patients had functional and anatomical success in terms of absence of epiphora and patent syringing and all the patients were cosmetically satisfied. Conclusion: Our study concludes that surgical repair of canalicular tear with Mini-Monoka stent is a safe and simple reliable technique, cosmetically satisfying with minimal manipulation giving high functional and anatomical success rate post repair.

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“…In our series, there were 6 (1.78%) patients with eyelid ectropion and 9 (2.66%) patients with stent extrusion and/or loss because the patients had rubbed their eyes and pulled the suture out. Some previous studies showed that urgent canalicular lacerations had an anatomic success rate of 25–94.1%, a functional success rate of 58–100% ( 8 , 26 , 28 , 29 ), and an extrusion rate of 5.88–23.2% ( 8 , 16 , 30 - 32 ). Our study had a higher anatomic success rate (95.86%), similar functional success rate (89.64%), and low postoperative complication rate (4.45%).…”

Section: Discussionmentioning

confidence: 99%

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

Han¹,

Chen²,

Zhang³

et al. 2022

Gland Surg

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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.

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Canalicular lacerations in a tertiary eye hospital: our experience with monocanalicular stents

Cited by 6 publications

References 20 publications

Multiple Approaches for Managing Complex Ophthalmic Blunt Trauma: A Case Report

Multiple Approaches for Managing Complex Ophthalmic Blunt Trauma: A Case Report

Surgical outcomes of canalicular tear repair with self-retaining Mini-Monoka stent in a tertiary care hospital in Kashmir in North India

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

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