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AIM: To investigate the effect of nasolacrimal duct packing combined with sodium hyaluronate gel injection in locating the nasal broken end in lacrimal canaliculus anastomosis which is difficult to find the broken end.METHODS:A total of 13 patients(13 eyes)with traumatic single lacrimal canaliculus rupture were treated in our hospital. RS lacrimal duct drainage tube was inserted into the lacrimal duct from intact lacrimal canaliculus to fill the nasolacrimal duct, then sodium hyaluronate gel was injected to make sodium hyaluronate gel overflow from the nasal broken end of fractured lacrimal canaliculus, which was used to locate the nasal broken end which was difficult to find and completed the lacrimal anastomosis operation.RESULTS: Among the patients with 13 eyes who were difficult to find the broken end, the nasolacrimal duct was filled with RS lacrimal duct drainage tube. After injection of sodium hyaluronate gel, the gel overflowed from the nasal broken end under direct vision of the microscope, and the lacrimal duct drainage tube was successfully inserted, and the success rate of finding the broken end was 100%. Thirteen eyes were extubated after being placed for 3mo, and then were followed up for 6mo. Among them, 9 eyes were cured, 3 eyes were markedly effective and 1 eye was ineffective. The cure rate was 69%, and the total effective rate was 92%.CONCLUSION: A new technique for rapid location of nasal broken end is proposed for patients in which are difficult to find the broken end. This method is simple to operate and requires a relatively low clinical experience. It is suitable for patients with different degrees of single lacrimal canaliculus rupture and can complete complex lacrimal canaliculus rupture anastomosis in a short time.
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Purpose: To study the clinical presentation, nasal endoscopic features, and outcomes of nasal endoscopy guided (NEG) bicanalicular intubation (BCI) in children with complex persistent congenital nasolacrimal duct obstruction (pCNLDO). Methods: A prospective, interventional study including eligible children (age ? 12 years) having complex pCNLDO. The demographics, number of previous probings, nasal endoscopy findings, and outcomes; were noted in all children who underwent NEG-BCI with Crawford's stents. Matting of eyelashes (MoE, upper, and lower eyelid), tear-film height (TFH), and fluorescein dye disappearance test (FDDT) was assessed pre and postoperatively. The minimum stent in-situ period was 12 weeks, and the minimum follow-up was 6 months (after stent removal). Results: Total 32 children (36 eyes) including 18 females (56.25%) were studied. At a mean age of 4.9 years, all children had epiphora and discharge with MoE (both upper and lower), raised TFH and positive FDDT. Previously, all children underwent conventional probing (s)- once in 12 (33.3%), twice in 18 (50%) and thrice in 6 (16.7%) eyes. The general ophthalmologists performed the majority (n = 21, 58.33%) of those. The BCI was performed under GA in all eyes, and at a mean follow-up of 8.5 months, the “complete” success was noted in 29 eyes (80.5%), 'partial' success in 4 (11.1%) and failure in 3 (8.3%). The stent prolapse was seen in three. Conclusion: NEG-BCI may provide a satisfactory resolution to complex pCNLDO after single or multiple failed probings. NEG provides confident and efficient management of coexistent intranasal complexities related to the inferior turbinate and meatus.
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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.
ABSTRACT
PURPOSE: The clinical effectiveness of monocanalicular or bicanalicular intubation with sequential probing was evaluated in patients over the age of 24 months with congenital nasolacrimal duct obstruction. METHODS: Patients over 24 months of age with congenital nasolacrimal duct obstruction who underwent monocanalicular intubation with sequential probing (19 patients, 20 eyes) or bicanalicular intubation with sequential probing (22 patients, 22 eyes) were studied. Success rates and complications were evaluated. Silicone tube was removed 6 months after surgery. Success was defined as no epiphora and no retention on fluorescein dye disappearance test. RESULTS: The success rate was 95.0% (19 eyes / 20 eyes) in the monocanalicular intubation group and complications included 7 cases of early tube dislodgement, which achieved successful outcome. The success rate was 82.6% (19 eyes / 22 eyes) in the bicanalicular intubation group and complications included 4 cases of punctal slitting, and 3 cases of tube extrusion. The success and complication rates were not significantly different between the 2 groups (p = 0.608, p = 1.000, respectively). CONCLUSIONS: In congenital nasolacrimal duct obstruction, the monocanalicular tube intubation group had similar success and complication rates to the bicanalicular tube intubation group. Silicone tube maintenance for 2 months in the monocanalicular group and for 3 months in the bicanalicular group was sufficient.
Subject(s)
Humans , Fluorescein , General Surgery , Intubation , Lacrimal Apparatus Diseases , Nasolacrimal Duct , SiliconesABSTRACT
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: Surgical effects of canaliculoplasty using Monoka(R) stent were evaluated in 18 cases of monocanalicular laceration. METHODS: Age was ranged from 6 to 57 years(mean 32.7 years), and most injuries occurred at the third and fourth decades. When epiphora was disappeared and irrigation solution was well passed without regurgitation, tube was removed four months following surgery, and the followed from four to twelve months postoperatively. RESULTS: Among 18 eyes, 17 eyes(94.4%) showed an improvement in the symptoms as well as the results of dye disappearance test. Postoperative complications included granuloma of the punctum(1 case) and conjunctival irritation(2 cases). There was no case of premature loss of the tube and furthermore some complications of bicanalicular intubation were avoidable with Monoka(R) stent. CONCLUSIONS: In conclusion, monocanaliculonasal intubation with Monoka(R) offers a useful alternative to bicanalicular intubation for the treatment of monocanalicular laceration.