Abstract
Purpose:
To report the epidemiological data, clinical profile, and outcomes of canalicular lacerations presenting to a specialized eye emergency room (Massachusetts Eye and Ear Infirmary).
Methods:
This is a retrospective review of 55 cases presenting to the Massachusetts Eye and Ear Infirmary with a canalicular laceration requiring surgical intervention by the oculoplastics service between May 2011 and December 2012. Variables assessed included age, sex, associated injuries, methods of surgical repair, and outcome.
Results:
Of the 55 patients reviewed with canalicular lacerations, the majority were males (72.7%). The average age at presentation was 32 years (range 1 to 86 years). The lower canaliculus was most frequently involved (67.2%), compared to 18.1% involving the upper, and 14.5% involving both upper and lower. The right eye was more often involved (56.3%) compared to the left eye (43.6%). The most common causes of canalicular laceration were animal bites (23.6%), assault (23.6%), and falls (21.8%). The repair was performed under local anesthesia in 28 of the patients (50.1%) and under general anesthesia in 27 (49.1%). The Mini-Monoka monocanalicular stent was used in 24 repairs (61.8%), the Ritleng intubation system used to repair 11 (20%), and Crawford lacrimal intubation sets used to repair 6 (10.1%). The average time to repair was 13.7 hours. Twelve patients (21.8%) were lost to follow-up. Of the remaining 43 patients for whom follow-up data is available, 35 (81.3%) achieved good anatomical outcome with no evidence of tearing. Of the 15 patients who took over 20 hours to undergo repair, 5 had complications (33.3%), compared to the overall failure rate of 18.7%. Open globe injury was associated in 4 (7.2%) of the injuries, 2 of which were associated with functional failure. The average number of days until stent removal was 65.4 days and the average duration of time until last follow-up appointment was 95.5 days.
Conclusions:
Our review demonstrates the epidemiology and experience of canalicular laceration repair at a tertiary referral center. Increased time to repair (>20 hours) was associated with a higher chance of having functional failure. Associated injury (i.e. open globe) was also associated with a higher chance of having functional failure. The lacerations most commonly occurred in males and were commonly caused by animal bites, assault, and falls.
Keywords: 742 trauma •
526 eyelid