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ABSTRACT Purpose: One of the most important disadvantages of using Mini Monoka stents in pediatric canalicular laceration repair is premature stent loss. In this study, we aimed to compare clinical outcomes between the use of Mini Monoka and Masterka monocanalicular stents in children and discuss the potential causes of premature stent loss. Methods: The medical records of 36 patients who underwent surgical repair of canalicular lacerations were retrospectively reviewed. Children aged <18 years who underwent canalicular laceration repair with either Mini Monoka or Masterka and had at least 6 months of follow-up after stent removal were included in the study. The patients' demographics, mechanism of injury, type of stent used, premature stent loss, and success rate were analyzed. Success was defined as stent removal without subsequent epiphora and premature stent loss. Results: Twenty-seven children fulfilled our study criteria, and their data were included in the analyses. Mini Monoka was used in 14 patients (51.9%), whereas Masterka was used in 13 patients (48.1%). The preoperative clinical features, including age, sex, and mechanism of injury, were similar between the two groups. The mean age was 8.3 ± 5.5 years in the Mini Monoka group and 7.8 ± 5.9 years in the Masterka group (p=0.61). Three patients in the Mini Monoka group (21.4%) underwent reoperation due to premature stent loss. No premature stent loss was observed in the Masterka group. As a result, the rate of success was 78.6% in the Mini Monoka group, whereas it was 100% in the Masterka group (p=0.22). Conclusions: Even though the two groups did not show any statistically significant difference in success rate, we did not observe any premature stent loss in the Masterka group. Further studies with larger and randomized series are warranted to elaborate on these findings.
RESUMO Objetivo: Uma das desvantagens mais importantes do uso de stents Mini Monoka no reparo de lacerações canaliculares pediátricas é a perda prematura do stent. Neste estudo, objetivamos comparar os resultados clínicos dos stents monocanaliculares Mini Monoka e Masterka em crianças e discutir as possíveis causas da perda prematura do stent. Métodos: Foram incluídos nesta revisão retrospectiva 36 pacientes <18 anos de idade que se submeteram ao reparo cirúrgico de uma laceração canalicular com um stent Mini Monoka ou Masterka e tiveram pelo menos 6 meses de acompanhamento após a remoção do stent. Foram analisados os dados demográficos, o mecanismo da lesão, o tipo de stent utilizado, a ocorrência de perda prematura de stent e o sucesso da intervenção. O sucesso foi definido como a ausência de epífora após a remoção do stent, sem a perda prematura deste. Resultados: Vinte e sete pacientes preencheram os critérios do presente estudo e foram incluídos nas análises. O stent Mini Monoka foi usado em 14 pacientes (51,9%), enquanto o Masterka foi usado em 13 pacientes (48,1%). As características clínicas pré-operatórias, incluindo idade, sexo e mecanismo de lesão, foram semelhantes entre os dois grupos. A média de idade foi de 8,3 ± 5,5 anos no grupo Mini Monoka e de 7,8 ± 5,9 anos no grupo Masterka (p=0,61). Três pacientes do grupo Mini-Monoka (21,4%) tiveram que ser operados novamente por perda prematura do stent. Nenhuma perda prematura do stent foi observada no grupo Masterka. Como resultado, a taxa de sucesso foi de 78,6% no grupo Mini Monoka e de 100% no grupo Masterka (p=0,22). Conclusões: Embora nenhuma diferença estatisticamente significativa tenha sido detectada entre os dois grupos em termos de taxas de sucesso, não observamos nenhuma perda prematura de stent no grupo Masterka. São necessários mais estudos, com séries maiores e randomizadas, para chegar a maiores conclusões sobre esses achados.
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Adolescent , Child , Child, Preschool , Humans , Stents , Lacerations , Retrospective StudiesABSTRACT
AIM: To investigate the application value of Worst lacrimal probe combined with modified lacrimal duct intubation in anastomosis of complex canalicular laceration.METHODS: Retrospective study. A total of 68 cases(68 eyes)with complex traumatic canalicular laceration treated in the ophthalmology department of the Second Affiliated Hospital of Zunyi Medical University from March 1, 2019 to March 31, 2021 were selected. They were divided into two groups according to the surgical methods, with 36 patients(36 eyes)who were treated with the Worst lacrimal probe to find the broken end of lacrimal duct combined with improved lacrimal duct threading intubation in group A, and 32 patients(32 eyes)who were treated with microscope to find the broken end of lacrimal duct and two-way intubation anastomosis canaliculus intubation in group B. The clinical efficacy, success rate of intraoperative search for the broken end of lacrimal duct, searching time, operation time, the degree of pain, postoperative ocular foreign body sensation and complications were compared between the two groups.RESULTS: The total effective rate of clinical efficacy in patients of group A was higher than that in group B(94% vs. 38%), the success rate of intraoperative search for broken end of lacrimal duct was higher than that in group B(100% vs. 47%), the searching time and operation time were shorter than those in group B, and the score of pain degree was lower than that in group B(all P&#x003C;0.05). The postoperative follow-up for 6mo-1a showed that the ocular foreign body sensation score, the incidence of lacrimal punctum rupture and morphological change, and the degree of tear overflow in group A were all lower than those in group B(all P&#x003C;0.05).CONCLUSION: Worst lacrimal probe combined with modified lacrimal duct intubation for the treatment of complex traumatic canalicular laceration can find the broken end of lacrimal duct more accurately, shorten the operation time, reduce the pain and foreign body sensation of patients, improve clinical efficacy and reduce the incidence of complications.
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@#AIM:To evaluate the clinical effect of two surgical methods based on a new type of lacrimal canalicular anastomosis device.<p>METHODS:In this research, we observed eighty relative cases(80 eyes)of traumatic lower canalicular laceration and all clinical assessments were performed during and after operation. Two kinds of probes were used for lacrimal canalicular anastomosis. The elastic pigtail probe was used for double lacrimal canalicular intubation(experience group)and the straight probe was used for single lacrimal canalicular intubation(control group).<p>RESULTS: The average time of intubation was 12.1±3.7min in experience group and 21.2±5.5min in control group(<i>t</i>=8.68, <i>P</i><0.05), and the average time of total operations was 28.9±5.6min in experience group and 34.4±6.8min in control group(<i>t</i>=3.95, <i>P</i><0.05). The rates of anatomic and functional success were 88%(35 cases)and 90%(36 cases)in experience group and 82%(33 cases)and 90%(36 cases)in control group at 12mo after operation(<i>P</i>>0.05). There were 4 cases of epiphora and 5 cases of lacrimal stenosis in the experience group, and 4 cases of epiphora, 7 cases of lacrimal stenosis, 5 cases of skin scar, 2 cases of catheter displacement and 1 case of eyelid relaxation in the control group(<i>P</i>>0.05). The intraoperative penetration rate was 100% in both groups, and the false path was not observed in this study.<p>CONCLUSION: The two methods of lacrimal canalicular anastomosis have different advantages, and they are both effective and feasible therapies in clinic.
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@#AIM: To investigate the positional relationship between the nasal ends of the lacerated lacrimal canaliculi, lacrimal caruncle, and medial canthal ligament, as well as its application in the lacrimal canalicular anastomosis.<p>METHODS: Sixty-five patients with traumatic lower canalicular laceration were selected. The distance from the lacrimal punctum to the temporal end was measured. The nasal ends were found under direct vision, and the positional relationship between the nasal ends, lacrimal caruncle and medial canthal ligament were quantitatively analyzed.<p>RESULTS: Totally 65 patients with canaliculus laceration, 39 patients had a distance of less than 6mm from the lacrimal punctum to the temporal end, where the nasal ends of 35 patients were located in the lacrimal caruncle area. There were 26 cases in which the distance from the lacrimal punctum to the temporal end was greater than 6mm, where the nasal ends of 24 cases were located in the medial canthal ligament area. The vertical distance between the nasal ends in the lacrimal caruncle area and the lacrimal mucosa was 2.1±0.7mm, and the vertical distance between the nasal ends in the medial canthal ligament area and the skin edge was 3.5±1.2mm.<p>CONCLUSION: The positions of nasal ends can be divided into the lacrimal caruncle area and the medial canthal ligament area, providing a basis for finding the nasal ends of the lacerated lacrimal canaliculi in the clinical practice.
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@#AIM: To evaluate the clinical efficacy of a newly designed silicone tube for the repair of canalicular lacerations.<p>METHODS: This was a prospective clinical study. Data were analyzed from 47 eyes of 47 patients presenting with traumatic canalicular laceration in our hospital from January 2013 to October 2015. The newly designed silicone tubes were inserted through the lacrimal punctum and left in the bicanaliculi for 3mo. Data of the lacrimal duct patency, epiphora, and eyelid shape were recorded.<p>RESULTS: Surgery was performed successfully in all cases. No complications associated with the silicone tubes occurred. In total, 41 patients(87.23%)achieved complete success, 4 patients(8.51%)achieved partial success, and 2 patients(4.26%)had surgical failure.<p>CONCLUSION: The newly designed silicone tube is an effective and atraumatic tool for the management of canalicular lacerations. The operation process is simple, and is easy to grasp for the surgeon.
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@#AIM:To analyze and compare the influence of different injury sites and injury types on surgical repair of canalicular laceration.<p>METHODS: A retrospective study was conducted on 87 cases(87 eyes)of traumatic canalicular laceration from January 2016 to August 2017, who were treated with silicone lacrimal drainage tube implantation. Lacrimal irrigation were performed 3mo and 6mo after surgery, and their respective operation results were evaluated. 3mo after surgery, lacrimal drainage tube were removed. Statisical analysis was proceeded on injury types, distances as well as the success rate of lacrimal passage irrigation.<p>RESULTS: Among the 87 cases of canalicular laceration, 29 eyes(33%)were in the PCL(proximal canalicular laceration)group, 41 eyes(47%)were in the MCL(medial canalicular laceration)group, and 17 eyes(20%)were in the DCL(distal canalicular laceration)group. There were 22 eyes(25%)of lacrimal canaliculi fracture caused by sharp instrument injury, including 18 eyes in the PCL group, 2 eyes in the MCL group and 2 eyes in the DCL group. There were 65 eyes(75%)of lacrimal canaliculi fracture caused by blunt trauma or collision, including 11 eyes in the PCL group, 39 eyes in the MCL group and 15 eyes in the DCL group. Six months after surgery, 72 eyes of lacrimal passage irrigation were successful, including 20 eyes in the PCL group, 36 eyes in the MCL group, and 16 eyes in the DCL group. The success rate of postoperative anatomic reduction in the three groups was 69%、88%、94%, respectively(<i>P</i>=0.047). There were 19 eyes of acute injury and 53 eyes of blunt injury with successful lacrimal duct irrigation respectively. The success rate of anatomical reduction was 86%、82%(<i>P</i>=0.605), respectively.<p>CONCLUSION: The canalicular laceration closed to lacrimal punctum is more vulnerable to cutting injury, while the canalicular laceration, which is near the lacrimal sac or between the lacrimal sac and center part of lacrimal punctum, can be more likely caused by lacerated wound. The success rate after operation is higher for patients with distal or medial canalicular laceration, and lower for those who with blunt wound location near the lacrimal punctum.
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Objective@#To report the epidemiology of canalicular lacerations and surgical outcomes of canalicular laceration repair with Mini-Monoka® (FCI Ophthalmics, Issy-les-Moulineaux, Cedex, France) intubation.@*Methods@#This is a retrospective interventional case series of patients who underwent Mini-Monoka® intubation in the repair of canalicular laceration from 2010 to 2015 at a tertiary state-owned hospital in Manila, Philippines. Patient demographics, surgical outcomes, and complications were analyzed.@*Results@#Fourteen patients (12 males and 2 females) underwent Mini-Monoka® intubation for monocanalicular laceration. The mean age at presentation was 27 years (range, 16-47 years). The mean duration of follow-up was 2.92 years (range, 1.28-6.15 years). Canalicular patency was achieved in 12 out of the 14 patients (86%). None of the 12 patients experienced epiphora following stent removal resulting in a functional success rate of 100%. Two patients had punctal slitting (14%). Premature stent loss occurred in 2 out of the 14 patients (14%).@*Conclusion@#Mini-Monoka® intubation is effective in maintaining the long-term anatomical patency of the lacerated canaliculus. It is a simple and minimally invasive procedure making it a safe and reasonable alternative to the traditional methods of canalicular repair.
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Lacerations , Eyelid DiseasesABSTRACT
Objective To investigate the effects of preset medial canthus ligament relaxation sutures in traumatic inferior canalicular laceration anastomosis.Methods A retrospective study was conducted in 32 patients (32 eyes) with inferior lacrimal canaliculus laceration who admitted to the Department of Ophthalmology from September 2014 to September 2016.In the procedures,after the broken end of the lower lacrimal canaliculus was found,4-0 suture was immediately placed between the ends of medial canthus ligament.After ensuring the satisfaction of the broken ends of the duct,the preset suture was released and the lacrimal stents were implanted.Anastomosis of lacrimal canaliculus laceration was performed with 8-0 absorbable suture,and subcutaneous tissue and skin were sutured with 6-0 absorbable suture.Then the lacrimal stents were removed 2-3 months after the operation.The patients were followed up 6-12 months for analysis of success rate and complications.Results Totally 29 patients were cured,2 patients improved,and 1 patient did not get better,with cure rate of 90.62％ and the effective rate of 96.88％.After surgery,lacrimal point tear presented in 2 eyes (6.25％),and notch within medial canthus was found in 1 eye (3.12％).Conclusion Medial canthus ligament relaxation suture can create a low tension healing environment for lacrimal canalicular laceration and improve the cure rate of canalicular laceration anastomosis.
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Objective To investigate the feasibility of injection of sodium hyaluronate gel to upper lacrimal puncta in locating the nasal broken end of inferior canalicular laceration.Methods Together 52 patients(52 eyes) with inferior canalicular laceration who collected from March 2013 to March 2016 in the Third Affiliated Hospital of Nanchang University underwent canaliculax laceration anastomosis combined with silicone tube.Injection of sodium hyaluronate gel to the upper lacrimal puncta was introduced in group A (n =32/32 eyes) for locating the nasal broken end of lower canaliculax laceration,while microscope for searching the nasal broken end served as group B (n =20/20 eyes).In both groups,the silicone tubes were implanted in the lacrimal passage for more than 3 months after locating the broken end successfully.All patients were followed up from 6 months to 12 months,with mean follow-up of (8.2 ± 1.6) months,and then clinical data of the distance of lower canalicular laceration between lacrimal canal,time consuming for locating the nasal broken end,effective rate and postoperative comphcations were compared between two groups.Results The procedures in all patients were successfully.In group A,23 patients were cured and 5 improved,but the operation was failed in 4 patients,of which 3 patients occurred upper or lower lacrimal punctas teax;while in group B,13 patients were cured and 4 improved,but the operation was failed in 3 patients,of which 2 patients occurred upper or lower lacrimal punctas tear.There was no significant difference in the the distance of between lower canalicular laceration and lacrimal canal in group A [6.5-8.3 (7.3 ± 0.6) mm] and group B [6.6-8.2 (7.2 ± 0.5) mm] (P =0.40).The time consuming for locating the nasal broken end in group A [1.5-5.5 (3.3 ± 1.3) min] was shorter than that in group B [5.0-26.0 (17.0 ± 6.0) min],with significant difference (P ＜ 0.001).Conclusion It is an easy and accurate method of injection of sodium hyaluronate gel to upper lacrimal puncta for locating the nasal broken end of lower canalicular laceration with less time.
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Objective To evaluate the intraoperative and postoperative effects of new type and modified probe in fractured lacrimal duct anastomosis.Methods Forty-nine patients with lower canalicular laceration were included in this study.The operation comparison was performed between the modified probe in a manner of synchronousintubation and the traditional pigtail probe.The differences of intraoperative effects were observed,and the clinical effects were assessed at postoperative 3,12 months.Results The average intubation time was (10.05±1.51) min in the observation group and (32.30±4.70) min in the control group,the difference was statistically significant (t=23.63,P＜0.01),the average whole operation time was (32.91 ± 3.98) min in the Observation group and (53.74± 5.48) min in the control group,the difference was staustically significant (t=15.71,P＜0.01).The rates of anatomic and functional success were 100.0％ (22 cases) and 90.9％ (20 cases) in the observation group,which were significantly higher than 70.4％ (19 cased) and 59.3％ (16 cases) in the control group,the difference was statistically significant (x2 =5.77,P＜0.05;x2 =6.23,P＜0.05).The punctal dilator was used by 18 times in the observation group and by 13 times in the control group,the difference was statistically significant (x2=5.91,P＜0.05),nevertheless no punctal incision was used.The rates of anatomic and functional success detected at 3 postoperative months,intraoperative once success and final success rates and postoperative complications showed no statistically significant differences(P＞0.05).Conclusion The modified probe provides a synchronous intubation new type operation mode,which simplifies the operation procedure,increases the operative success rate and partially reduces the occurrence of postoperative complications.
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Objective To evaluate the intraoperative and postoperative effects of new type and modified probe in fractured lacrimal duct anastomosis.Methods Forty-nine patients with lower canalicular laceration were included in this study.The operation comparison was performed between the modified probe in a manner of synchronousintubation and the traditional pigtail probe.The differences of intraoperative effects were observed,and the clinical effects were assessed at postoperative 3,12 months.Results The average intubation time was (10.05±1.51) min in the observation group and (32.30±4.70) min in the control group,the difference was statistically significant (t=23.63,P＜0.01),the average whole operation time was (32.91 ± 3.98) min in the Observation group and (53.74± 5.48) min in the control group,the difference was staustically significant (t=15.71,P＜0.01).The rates of anatomic and functional success were 100.0％ (22 cases) and 90.9％ (20 cases) in the observation group,which were significantly higher than 70.4％ (19 cased) and 59.3％ (16 cases) in the control group,the difference was statistically significant (x2 =5.77,P＜0.05;x2 =6.23,P＜0.05).The punctal dilator was used by 18 times in the observation group and by 13 times in the control group,the difference was statistically significant (x2=5.91,P＜0.05),nevertheless no punctal incision was used.The rates of anatomic and functional success detected at 3 postoperative months,intraoperative once success and final success rates and postoperative complications showed no statistically significant differences(P＞0.05).Conclusion The modified probe provides a synchronous intubation new type operation mode,which simplifies the operation procedure,increases the operative success rate and partially reduces the occurrence of postoperative complications.
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To investigate a simple and effective method of lacrimal canalicular laceration of lacrimal canalicular nasal side in the broken end of the lower lacrimal canaliculus and to evaluate the curative effect after lower lacrimal canaliculi laceration anastomosis. ●METHODS: ln 55 cases ( 55 eyes) of lower lacrimal canalicular laceration patients, in order to look for nasal fracture of lower lacrimal canaliculus broken end. Most of them were under direct vision using surgical microscope, only a few patients injecting physiological saline ( or sodium hyaluronate when necessary ) from the upper lacrimal puncta. With 0. 8mm outer diameter hollow silicone tube as the support material to anastomose surrounding tissue of the lacrimal canaliculus 2 - 3 needles. Silicone tube was indwelled for 2 - 3mo. All patients were followed up 6-24mo. ● RESULTS: ln 55 cases ( 55 eyes ) of lower lacrimal canalicular laceration patients were all successful anastomosed. The cure rate and the effective rate were 89. 1% (49 / 55), 9. 1% cases improved (5 / 55), only 1 case was invalid (1. 8%). ●CONCLUSlON: This method is an effective method of lacrimal canaliculus anastomosis operation and it is simple and effective, suitable for application in a hospital with micro operation conditions.
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To evaluate the outcome of 20G silicone rod as monocanalicular stent in canalicular lacerations. Retrospective case series involving patients between July 2006 and June 2010. Fourteen canalicular repairs in 12 consecutive patients were done in the study period. Eleven were male and mean age was 30.5 years. A single canaliculus was involved in 10 patients and associated injury to the globe was noted in 3 patients. The median lag time between injury and repair was 3 (range 1-9) days. The mean duration of stenting was 6.9 (SD 3.2) weeks. Spontaneous extrusion of monocanalicular stent occurred in 3 patients. Patency on syringing was noted in 10 (70%) canaliculi over a median follow up of 7 (range 2-17) months. 20G silicone rod may be used as an effective and economical alternative in canalicular lacration repairs.
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PURPOSE: To identify risk factors influencing the anatomical and functional outcomes of canaliculoplasty in canalicular laceration patients. METHODS: A retrospective investigation of 122 eyes of 122 patients diagnosed with canalicular laceration and treated in our hospital from January 2000 to October 2008 was conducted. Sex, age, cause and location of laceration, combined injury, preoperative duration, combined operation, duration of follow-up, and anatomical and functional outcomes of canaliculoplasty were investigated. RESULTS: The mean age of the 122 patients was 41.2 years; 102 (83.6%) were men, and 20 (16.4%) were women. The most common cause and combined injury of laceration was sharp object Injury (20.5%) and orbital wall fracture (14.7%). No statistically significant correlation was found between pretreatment duration, duration of silicone tube insertion, and anatomical outcome. The causes of decreasing functional outcome of canaliculoplasty were traumatic facial nerve palsy, cicatrical entropion and ectropion, and partial canalicular obstruction. CONCLUSIONS: Repair of a combined eyelid injury close to the normal anatomical structure is an important factor for increasing the functional outcome.
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Female , Humans , Male , Ectropion , Entropion , Eye , Eyelids , Facial Nerve , Follow-Up Studies , Lacerations , Orbit , Paralysis , Retrospective Studies , Risk Factors , SiliconesABSTRACT
PURPOSE: Canalicular laceration is relatively common due to its exposed, vulnerable location in case of facial trauma. Conjunctivodacryocystorhinostomy has been the standard treatment for canalicular obstruction secondary to unrepaired canalicular laceration. In spite of a high rate of relieving tear-duct obstruction, this method is noted to be associated with low rate of patient satisfaction and a number of complications. The goal of this study is to report the good results of delayed lacrimal stent implantation with Mini Monoka(R) for patients whose canaliculi were not repaired by initial surgery. METHODS: From May of 2005 to February of 2007, four patients who underwent delayed lacrimal stent implantation using Mini Monoka(R) in canalicular laceration were retrospectively reviewed. First, the previous scar incision was made over the lower lid and we identified the cut end of proximal lacerated canaliculus. The Mini Monoka(R) was passed through the punctum to the cut end of the proximal lacerated canaliculus. We identified the cut end of the distal lacerated canaliculus, whose cut end has rolled white edges after careful excision of the scarred lid tissue. We then passed Mini Monoka(R) through the lacerated inferior canaliculus. Using an operating microscope, we placed three interrupted sutures of 8-0 Ethilon to join the canalicular ends. Silicone stent was left in place for 6 months. The mean age of the patients was 48.5 years (range, 35 to 59 years). The time interval from initial trauma to delayed lacrimal stent implantation was between 3 and 31 days. Follow-up periods ranged from 12 and 20 months. RESULTS: The results of reconstruction were classified into normal, fair and poor. Patent lacrimal drainage systems were achieved in three of the four cases. In one case, epiphora was encountered. No cases of stent displacement, conjunctivitis or granuloma formation were encountered. CONCLUSIONS: Even though canalicular reconstruction was delayed for a long time, attempting canalicular reconstruction would be acceptable before considering secondary operations like dacryocystorhinostomy and conjunctivodacryocystorhinostomy.
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Humans , Cicatrix , Conjunctivitis , Dacryocystorhinostomy , Displacement, Psychological , Drainage , Follow-Up Studies , Granuloma , Hypogonadism , Lacerations , Lacrimal Apparatus Diseases , Mitochondrial Diseases , Nylons , Ophthalmoplegia , Patient Satisfaction , Retrospective Studies , Silicones , Stents , SuturesABSTRACT
PURPOSE: To evaluate clinical characteristics and outcome of repair of canalicular laceration with Crawford stent. METHODS: All 40 patients who underwent canalicular laceration repair from 2004 to 2007 in the hospital were retrospectively reviewed. Demographics, cause of canalicular injury, surgical management with Crawford stent, and its outcome were analyzed RESULTS: Most cases were male with step wound (34 cases 85%). Average age of fourty patients was 41.7 years old. Outcome had varied depending on the time of surgery, the location of laceration, the suture method, the wound condition, and the duration for stent. Maintaining silicone tube more than three months, and surgical approach within forty-eight hours resulted in statistically significant results. CONCLUSIONS: The outcome of canalicular laceration was better when surgical approach was done within forty-eight hours and silicone tube was maintained more than three months.
Subject(s)
Humans , Male , Demography , Intraoperative Complications , Lacerations , Retrospective Studies , Silicones , Stents , SuturesABSTRACT
PURPOSE: To introduce a modified technique of bicanalicular silicone tube intubation, which can reduce slitting of the canaliculus and protrusion of the tube. METHODS: This study included 46 patients who underwent modified surgery for Congenital Nasolacrimal Duct (CNLD) obstruction. To be included in this study, patients were older than 13 months and had a history of failed probing. Using our modified technique, tube lengths can be appropriately adjusted by either pulling or releasing the tube at the medial canthus until a tube loop is in place without any tension to the upper and lower canaliculi. Two threads of silicone tube were tied together using 5-0 nylon over a silicone sponge (5x5 mm) and left within the nasal cavity for several months without fixation to the nasal mucosa. A successful surgery was clinically defined as no epiphora and no dye retention in the conjunctival sac. RESULTS: The mean age of patients at the time of surgery was 32.8 (+/-18.9) months. There were 22 males and 24 females. Prior to intubation, patients had been probed an average of 1.5 (+/-1.3) times, and the mean follow-up period was 12.6 (+/-14.2) months. The tube was removed at 5.4 (+/-1.3) months postoperatively on average. The success rates were 88%. Tube protrusions occurred in three eyes, and canalicular splittings were recorded in two eyes. No other serious complications were encountered. CONCLUSIONS: This new technique might enable us to remarkably reduce both protrusion and slitting of the canaliculus in bicanalicular silicone intubation for congenital nasolacrimal duct obstruction.
Subject(s)
Female , Humans , Male , Eye , Follow-Up Studies , Hypogonadism , Intubation , Lacrimal Apparatus Diseases , Mitochondrial Diseases , Nasal Cavity , Nasal Mucosa , Nasolacrimal Duct , Nylons , Ophthalmoplegia , Porifera , Retention, Psychology , SiliconesABSTRACT
Objective To observe the effect of double-passage canalicular intubation in repair of lacrimal cancliculi laceration.Methods 21 cases of canaliculi laceration were treated by canaliculoplasty,anastomosised with epidural tube and performed with double-passage canalicular intubation.The tube left time was three months.Results 21 cases had all been cured,1 case complained about foreign body feeling.There were no complaints about cosmesis,and all cases could be treated with good cooperation till the tubes were removed.Conclusion Double-passage canalicular intubation with the epidural tube is a reliable and satisfactory method in canaliculoplasty.
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PURPOSE: To examine the results of minimal stitch on the restoration of tissue after canalicular laceration. METHODS: We have operated using sutures of tissues around canalicular laceration by inserting bicanalicular silicone stents and minimal horizontal mattress sutures with 8-0 Vicryl in cases of canalicular laceration instead of the existing method for the past 6 years. The ages of patients ranged from 2 to 76 years (average age 39.8+/-17.4 years), with most patients in their thirties (12 patients, 40%), 30 cases underwent canalicular repair with minimal stitch and bicanalicular silicone stent insertion within 24 hours after trauma. The silicone stent was removed 3 months after the operation if the patient did not complain of epiphroa while the canalicular remained open. RESULTS: Twenty-five eyes (83.3%) showed symptom improvement and good passage in lacrimal syringing test in 4~12 months (average: 6.8+/-2.2 months) of follow-up study. Complications included one case each of fistula formation, stent prolapse, and wound infection, and two cases of canalicular stenosis. CONCLUSIONS: We recommend this method because of its satisfying success ratio.
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Humans , Constriction, Pathologic , Eye , Fistula , Follow-Up Studies , Lacerations , Polyglactin 910 , Prolapse , Silicones , Stents , Sutures , Wound InfectionABSTRACT
AIM:To evaluate the efficacy and safety of "one-stitch anastomosis through the skin" repair of canalicular laceration.METHODS:The data of 32 cases (32 eyes) of canalicular laceration who underwent repair of lacerated canaliculi with one-stitch anastomosis through the skin were retrospectively reviewed, inferior canalicular laceration in 29 patients,superior canalicular laceration in 1 patient, 2 cases involving both the inferior and superior canalicular laceration. All the operations were performed under surgical microscope, 5-0 silk sutures were used and silicone tube of 0.8mm diameter was employed in intubation. The stents were left in place for 3 months postoperatively and then removed. The follow-up period was 1 to 36 months.RESULTS: In 32 patients, 28 (88%)patients were cured entirely, 3 (9%)patients were meliorated, and 1 (3%)patient had no effects. A total of 29 patients complied with scheduled follow up 1-36 months (average 12 months) after stent removal, and 3 patients were lost in follow-up. All the patients had got good recovery of eyelid laceration with no traumatic deformity in eyelid and canthus.CONCLUSION: In "one-stitch anastomosis through the skin"repair of canalicular laceration, the cut ends could be anastomosed directly,for there was no suture remained in the wound permanently, so there was no suture-related granuloma which might cause obstruction or stenosis of canaliculi. It was simple, economical ,effective and safe.