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

Abstract

Background: To evaluate the etiology of lacrimal canalicular laceration and explore possible risk factors influencing prognosis. Methods: A total of 142 patients (142 eyes) with lacrimal canalicular laceration were reviewed and surgically repaired using canalicular anastomosis combined with bicanalicular stent intubation between March 2017 and March 2018. The analyzed data contained demographic information, types of trauma, injury location, associated additional ocular injuries and surgerical outcomes at follow-up. The main outcome measures were anatomic success rate, functional success rate, and the complications of surgery.Results: The mean patient age was 42.07 years(ranging from 1-75 years) and 112 (78.87%) were men. Upper and lower canalicular lacerations were found in 14 (9.86%) and 112 patients (78.87%), respectively, and both canalicular lacerations were found in 16 patients (11.27%). Electric bike accidents were the leading cause of injury with 76 patients (53.52%). There were 100 (70.42%) patients who had lid laceration without tarsal plate fracture and 42 (29.58%) patients who had lid laceration with tarsal plate fracture. Anatomic success rate was 98.59%, and functional success rate was 83.8%. Functional reconstruction failure rates were higher in patients with indirect injuries, lid laceration with tarsal plate fracture, and with punctum splitting(P<0.05). Surgical Complications were detected in the form of lacrimal punctum ectropion in 3 (2.11%) patients, punctum splitting in 2 (1.41%) patients, stent extrusion and loss in 2 (1.41%) patients. Conclusions: Electric bike accidents have become the leading cause of injury instead of the motor vehicle accidents because of changes in lifestyle. The indirect injuries, lid laceration with tarsal plate fracture and with punctum splitting, were significantly more likely to lead to a poor prognosis, as comfirmed by the lower functional success rate of surgery.