Retrospective study on the influencing factors of lacrimal canalicular rupture repair

Abstract

AIM:To analyze and compare the influence of different injury sites and injury types on surgical repair of canalicular laceration.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.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(P=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%(P=0.605), respectively.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.

Keywords

• canalicular laceration
• lacrimal canalicular anastomosis
• cutting injury
• blunt injury