April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Management of Canalicular Lacerations: Epidemiological Aspects and Experience
Author Affiliations & Notes
  • Ashley Campbell
    Ophthalmic Plastic Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA
    Ophthalmology, Harvard Medical School, Boston, MA
  • Dawn K De Castro
    Ophthalmic Plastic Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA
    Ophthalmology, Harvard Medical School, Boston, MA
  • Nahyoung Grace Lee
    Ophthalmic Plastic Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA
    Ophthalmology, Harvard Medical School, Boston, MA
  • Suzanne K Freitag
    Ophthalmic Plastic Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA
    Ophthalmology, Harvard Medical School, Boston, MA
  • Daniel R Lefebvre
    Ophthalmic Plastic Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA
    Ophthalmology, Harvard Medical School, Boston, MA
  • Footnotes
    Commercial Relationships Ashley Campbell, None; Dawn De Castro, None; Nahyoung Lee, None; Suzanne Freitag, None; Daniel Lefebvre, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 5477. doi:https://doi.org/
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      Ashley Campbell, Dawn K De Castro, Nahyoung Grace Lee, Suzanne K Freitag, Daniel R Lefebvre; Management of Canalicular Lacerations: Epidemiological Aspects and Experience. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5477. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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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  
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