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Blair Kristin Armstrong, Michael Rabinowitz, Brianna Kenney, Robert Penne; Surgical and Epidemiologic Factors Affecting Canalicular Laceration Repair with the Mini Monoka Monocanalicular Stent. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2790.
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To review the demographics, mechanisms of injury, surgical variables, complications, and outcomes of patients who sustained a canalicular involving eyelid laceration surgically reconstructed with the Mini Monoka monocanalicular stent (FCI Ophthalmics, France).
Retrospective analysis with survey component. Patients were identified through electronic billing records and paper charts reviewed for demographic data, injury details, operative report, and visit information. Ongoing data collection is underway, utilizing ophthalmology emergency department discharge records. All patients will be contacted via telephone survey for data standardization.
59 canalicular lacerations in 57 patients were identified. The mean age was 34.6 (range 0-81 years). 68.4% of patients were male and 31.6% were female; 51% were Caucasian, 31.4% Black, and 17.6% Hispanic. Canalicular lacerations were most commonly due to blunt accidental trauma (32.7%), sharp accidental trauma (23.1%), and animal bite (19.2%). 75.5% of patients underwent canalicular repair in the operating room under general anesthesia and 25.5% in a minor procedure room with local anesthesia. 55.3% had surgery within 12-24 hours of laceration, 27.7% <12 hours, 12.8% in 25-48 hours, and 4.3% at > 48 hours. Stents were removed at a mean value of 21.77 weeks (range: 6 -152). 57.1% did not have documented stent removal at last follow up visit. Complications included extrusion (n=13 patients) and infection (n=4 patients). Patients who did not undergo stent removal had a higher complication rate (p<0.001) and removal at an average of 16 weeks conferred fewer complications than longer duration of stent placement, average 58 weeks (p<0.001). Tearing and epiphora were more common in patients with >24 hours between injury and repair (p = 0.014).
Canalicular lacerations are most common in young males and often secondary to blunt or sharp accidental trauma. Delayed repair results in higher incidence of tearing and epiphora. Timing of tube removal is directly related to complication rate.
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