Canalicular laceration repair using a self-retaining, bicanalicular, hydrophilic nasolacrimal stent.

Purpose: To evaluate outcomes of primary eyelid and canalicular laceration repair using a self-retaining bicanalicular hydrophilic nasolacrimal stent.Methods: This study is a retrospective review of seven patients with canalicular laceration primarily repaired with a self-retaining bicanalicular nasolacrimal stent within 72 hours of initial injury. After lacrimal intubation, repair was performed by reapproximation of the lacerated tissues. Data collection included ophthalmic examination, mechanism of injury, involvement of upper/lower/common canaliculi, symptoms of epiphora, operative time, stent extrusion and canalicular irrigation.Results: Seven patients with monocanalicular laceration were repaired using the self-retaining bicanalicular nasolacrimal stent. The stent was left in place an average of 5 months. The average operative time was 29.3 minutes. None of the stents extruded prior to removal. After 5 months, the stent was removed successfully without difficulty. All patients reported subjective improvement in epiphora, with complete resolution of symptoms. Anatomic success was confirmed with irrigation in all cases. There were no complications associated with usage of the self-retaining bicanalicular nasolacrimal stent.Conclusions: Primary repair of canalicular lacerations can be successfully performed with a self-retaining bicanalicular nasolacrimal stent. This stent has several advantages, including potentially faster operative times, no need for intranasal fixation or retrieval, easier intubation in the lacrimal system, and improved anatomic reapproximation of lacerated tissues.

Analysis of the effectiveness and surgical timing for the treatment of lacrimal duct obstruction secondary to chemotherapy by bicanalicular stent intubation / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the effectiveness and surgical timing for the treatment of lacrimal duct obstruction secondary to chemotherapy by bicanalicular stent intubation.<p>METHODS:A retrospective analysis was performed on 50 patients of 100 eyes who underwent bicanalicular stent intubation from July 2015 to April 2018 in our hospital, all the patients were suffered from lacrimal duct obstruction secondary to chemotherapy. They were divided into three groups according to the length of time between the date of surgery and the date of first chemotherapy. All patients were followed for at least 12mo post-operation. Ophthalmic physical examinations and lacrimal duct irrigations were recorded.<p>RESULTS: Evaluating the effectiveness 12mo after surgery. The efficiency of group 1, group 2 and group 3 were 83.3%, 61.1%, 30.0%, respectively. With the delay of surgical intervention, the efficiency decreased significantly, and the difference was statistically significant(χ2=18.322, <i>P</i><0.01).<p>CONCLUSION: Early diagnosis and surgical intervention of lacrimal duct obstruction secondary to chemotherapy with 5-FU, S-1 or docetaxel in patients with malignant tumors are of great significance to improve the success rate of surgery.

Old canalicular laceration repair: a retrospective study of the curative effects and prognostic factors.

AIM: To investigate the epidemiology and surgical outcomes of old canalicular laceration and analyze the variables impacting on the prognosis of reparation. METHODS: A retrospective review of all old canalicular laceration repairs from Jan. 1, 2008 to Dec. 30, 2015 was performed. Analyzed data included demographics, mechanisms of injury, the time from injury to repair, causes for delayed repair, old associated injuries, the types of surgery, and the effects of repair using canaliculus anastomosis combined with bicanalicular stent intubation. RESULTS: Totally 148 patients with old canalicular laceration received surgical repair and were enrolled. The mean age at presentation was 32.52 years old (ranged from 3 to 63 years old). The 110 patients (74.32%) were male and 127 patients (85.81%) were adults (≥18 years old). The old upper, lower, and bicanalicular lacerations were found in 5 (3.38%), 39 (26.35%), and 104 patients (70.27%), respectively. The mechanism of old injury was primarily due to motor vehicle accidents (n=53, 35.81%). The mean time from injury to repair was 43.61mo (ranged from 1 to 360mo). Associated old ocular and orbit injuries were found in 65 patients (43.92%), and chronic dacryocystitis in 18 patients (12.16%). The main cause of delayed repair was that doctors or patients didn't pay attention to the canalicular laceration because of the concurrent severe injuries (n=71, 47.97%). Totally 136 patients (91.89%) with old canalicular laceration underwent canaliculus anastomosis combined with bicanalicular stent intubation. In all of them, 20 patients (13.51%) were combined with dacryocystorhinostomy. In these cases, 132 patients (97.06%) attained anatomic success, 121 patients (88.97%) reported no epiphora (functional success), 11 patients (8.09%) reported significant epiphora anesis (functional improvement), and 4 (2.94%) reported no significant anesis (functional failure). Rates of anatomic success and functional success were significantly correlated with different canaliculus involved. However, rates of anatomic success and functional success were not significantly affected by the time from injury to repair. CONCLUSION: The canalicular anastomosis combined with bicanalicular stent intubation could act as an effective therapeutics for old canalicular laceration.

Endoscopic laser-assisted dacryocistorhinostomy DCR with the placement of a customised silicone and Teflon bicanalicular stent Endoscopic laser-assisted dacryocystorhinostomy (DCR).

INTRODUCTION: We present our experience in endoscopic laser assisted dacryocystorhinostomy (DCR) analyzing the results obtained with a new technique that involves placing bicanalicolar silicone stent more Teflon tube, in combination with paraseptal silastic sheet. MATERIALS AND METHODS: In our study 49 of 57 patients (85%) at a mean follow up of at least 12 months have not reported epiphora or more episodes of acute dacryocystitis. RESULTS: 49 out of the 57 patients (85%) in our group reported no additional epiphora or episodes of acute dacryocystitis. CONCLUSIONS: Endoscopic DCR is currently the gold standard for sac and post-sac stenosis given the minimal invasiveness of the procedure and the long-term results that appear comparable to those obtained with extrinsic DCR. The principal problem is cicatricial stenosis that can occlude the stoma over time.

The Effectiveness of Canaliculoplasty Using Mini-Monoka(r) or Bicanalicular Stent for Repair of Upper and Lower Canalicular Laceration

A retrospective study was designed to compare postoperative effect in 45 cases of patients of bicanaliculoplasty with lower canaliculoplasty. The 30 of 45 cases received bicanalicular stent and the 15 cases had lower canaliculoplasty using Mini-Monoka(r) (lower canaliculoplasty).The age ranged from 5 to 67 years (mean: 37.1 years).Thirty-two patients were men and 6 patients were women.After follow-up period of 6 to 12 month (mean 8.6 month), 27 cases (90%)of bicanaliculoplasty and 9 cases (60%)of lower canaliculoplasty became recanalized well. Postoperative complications included granuloma of the punctum in both cases (6 cases of bicanaliculoplasty, 3 case of lower canaliculoplasty)and loss of tube (3 case of bicanaliculoplasty, 6 case of lower canaliculoplasty). When both upper and lower canalicula were injuried, better result was seen in the method of lower canaliculoplasty using Mini-Monoka(r) than that of bicanaliculoplasty using bicanalicular stent. Both bicanalicular stent and Mini-Monoka(r) were good for canaliculoplasty.

Canaliculoplasty Using Mini-Monoka or Bicanalicular Stent for Repair of Canalicular Laceration

A retrospective study was designed to evaluate the clinical characteristics of canalicular injury including causes and associated ocular traumas, time of operation, and appropriate operating methods and materials. The authors retrospectively reviewed the charts of 60 patients who underwent repair of lacerated canaliculi from June 1992 to September 1997 at Chonnam University Hospital. Most injuries occurred at second and third decades(30, 50%). The most common cause was fist blow(19, 31.7%). Among a total of 44 patients who could be followed for more than 6 months, 30 of 32 eyes(93.8%) who were repaired with Mini-Monoka and 11 of 12 eyes(91.7%) with bicanalicular stent met with successful results. There were 8 prolapses of tube, 2 granuloma formations, 2 wound infections, one punctal slit, and one canalicular stenosis as the postoperative complication. All of them ware treated successfully. Canaliculoplasty was not successful in cases that operation was performed 48 hours after trauma and the tube was prolapsed within 3 months. No significant associations were found between presence of postoperative epiphora and sex, causes of injury, location of injury and type of canalicular stent. Canaliculoplasty with either Mini-Monoka or bicanalicular stent had successful postoperative outcomes without any significant complications.

Clinical Experience of Monocanaliculonasal Stent in Canalicular Laceration

Repairing of canalicular laceration has some controversies on the golden timing of surgery, the suture method, the materials of stent, and the need of repairing the upper canaliculus in case of involving upper canaliculus. Until recently, reconstruction of the canaliculus with a bicanalicular silicone stent has been accepted as the most reasonable method. But the bicanalicular stent has some disadvantages including cosmetic problem and the possibility of injuries to the normal canaliculus during intubation. The authors used newly developed monocanaliculonasal stents in nine patients with traumatic canalicular laceration and it showed the absence of epiphora the cosmetically superiority, and the simplicity of intubation, compared with bicanalicualr silicone stent.