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Scott W. Yeates, Faruk Orge; Repair of pediatric canalicular lacerations using monocanalicular Monoka stent. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6757.
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In lid lacerations with canalicular involvement the goal is to promptly identify structures and repair the canalicular anatomy to provide adequate function of the lacrimal drainage system. Repairing canalicular lacerations can be complicated due to difficulty with identification and intubation of the proximal injured system, and repairing the canalicular epithelium. In cases of canalicular trauma of one lid, it is important to avoid damage in the unaffected canaliculus to keep as the remaining possible drainage path. The repair may fail and structures may scar secondary to the trauma. The purpose of this study is to review surgical repair of pediatric canalicular lacerations using a viscoelastic assisted monocanalicular technique.
The charts of pediatric patients undergoing surgical repair of lid lacerations with canalicular involvement via viscoelastic assisted monocanalicular stenting were retrospectively reviewed. This technique uses viscoelastic material to help locate and intubate the torn canalicula and facilitate ease in stenting. Surgical outcomes including functional and anatomic results were reviewed.
The charts of 13 patients who underwent surgical repair were reviewed. 12 of the 13 were successful primarily. In one case the proximal edge could not be identified since it was torn at the base of the lacrimal sac, however due to the intact upper canalicular system the patient was asymptomatic. All the children had good anatomic and functional outcomes without long term complications.
The viscoelastic assisted repair with a monocanalicular stent is a successful model to restore canalicular anatomy and function. This technique avoids the possible iatrogenic trauma to the uninjured canaliculus that can be inflicted with bicanalicular intubation or pigtail instrumentation for identification of the torn edge.
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