alexa Management of canalicular lacerations: epidemiological aspects and experience with Mini-Monoka monocanalicular stent.


Optometry: Open Access

Author(s): Naik MN, Kelapure A, Rath S, Honavar SG, Naik MN, Kelapure A, Rath S, Honavar SG

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Abstract PURPOSE: To report the epidemiological data, clinical profile, and surgical outcome of canalicular lacerations in an Indian population. DESIGN: Retrospective interventional case series. METHODS: All patients who underwent canalicular laceration repair from July 1, 2002 to June 30, 2005 at a tertiary eye care center were retrospectively reviewed. Demographics, cause of eyelid injury, associated ocular injury, surgical management with Mini-Monoka monocanalicular stent, and its outcome were analyzed. RESULTS: Sixty-six patients underwent eyelid laceration repair, of which 24 (36\%) had involvement of the canalicular system. The mean age at presentation was 16 years (range, 10 months to 52 years); 20 (83.3\%) patients were males. Mode of injury included the blouse-hook fastener in five (20.8\%) breast-feeding infants, bicycle handle injury in four (16.7\%) children, and metal rod injury in five (20.8\%) adults. Lower canaliculus was involved in 13 (54.1\%), upper in eight (33.3\%), and both in three (12.5\%) patients. Simultaneous globe injury was noted in six (25\%) patients, five (83.3\%) of which had upper canalicular involvement. Twenty-seven canalicular lacerations (24 patients) underwent stenting with the Mini-Monoka monocanalicular stent. Three (11.1\%) stents extruded within one month. At the final follow-up (mean, 18.5 months), canalicular block was noted in two (10\%) out of 20 patients; none had epiphora. CONCLUSION: Canalicular involvement occurs in 36\% of eyelid injuries. Injury by the "blouse-hook fastener" is unique to infants in the Indian context. Simultaneous globe injury is present in 25\% of cases, especially when the upper canaliculus is involved. Mini-Monoka stent extrusions occur within one month. With an 11.1\% extrusion rate, Mini-Monoka stents achieved good anatomical (90\%) and functional (100\%) success in the management of canalicular injury. This article was published in Am J Ophthalmol and referenced in Optometry: Open Access

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