Risk factors for persistent epiphora following successful canalicular laceration repair.

AIM: To identify the risk factors of epiphora in patients with anatomical patency after surgical repair of canalicular laceration. METHODS: This retrospective case series included 178 cases of canalicular laceration repair from 2005 to 2012. Demographic data collected from each patient included age, sex, type of injury, distance from the distal lacerated end of the canaliculus to the punctum, the severity score for the structural abnormity of the medial canthus, the duration of stent placement, and the timing of surgery. The risk factors for epiphora were evaluated using Logistic regression models. RESULTS: Among the 178 cases, 45 (25.3%) with lacrimal patency after irrigation had symptomatic epiphora at the final follow-up. Patients' sex, age, type of injury, duration of stent placement, timing of surgery, and concurrent trauma were not found to be significantly associated with symptomatic epiphora after surgical repair of the lacerated canaliculus (P>0.05). A distance of more than 5 mm from the distal cut end to the punctum was closely and significantly associated with symptomatic epiphora after surgical repair of the lacerated canaliculus (P<0.01). Symptomatic epiphora was significantly more frequent in patients with higher severity scores for structural abnormities of the medial canthus (P<0.01). CONCLUSION: Our results indicate that the risk factors for postoperative symptomatic epiphora include a further distance between the distal cut end and the lacrimal punctum and a higher severity score for structural abnormities of the medial canthus. These findings could be used to prognosticate postoperative symptomatic epiphora.

[The correlative factors of darkroom provocative test in anterior segment parameters].

OBJECTIVE: To investigate the correlative anterior segment parameters of positive darkroom provocative test in patients with narrow anterior chamber angles. METHODS: It was a retrospective case series study. Two hundred and sixty patients [36 males and 224 females, mean age (59.6 ± 9.3) years] with narrow anterior chamber angles underwent darkroom provocative test and UBM scan were analyzed retrospectively. Anterior segment parameters including anterior chamber depth (ACD), pupil diameter (PD), lens vault (LV), peripheral iris thickness (IT), iris convex (IC), anterior chamber angle open distance (AOD), trabecular-meshwork ciliary process angle (TCPA) and the number of appositional angle closure (NPAC) were quantitatively analyzed. Correlative factors of positive results were analysis by both single factor and multiple-factor analysis. RESULTS: Seventy-one (27.3%) of the 260 patients had positive results in the darkroom provocative test. Males (15 out of 36) had statistically higher positive result rate than females (56 out of 224) (M: 41.7% vs. F:25.0%, χ(2) = 4.340, P = 0.037). In single factor analysis, male (OR = 2.14), AOD (OR = 0.98), IT (OR = 1.68) and NPAC (OR = 2.24) were correlative factors for positive results. In multiple-factor analysis, only IT (OR = 1.47) and NPAC (OR = 1.70) were independent risk factors of positive results. CONCLUSIONS: Positive darkroom provocative test is correlated to parameters of anterior chamber angle and iris, while IT and NPAC are independent correlative factors in patients with narrow anterior chamber angle.