Canalicular lacerations: Factors predicting outcome at a tertiary eye care centre. (2nd January 2017)

• Record Type: Journal Article
• Authors: Singh, Swati; Ganguly, Anasua; Hardas, Apurva; Tripathy, Devjyoti; Rath, Suryasnata
• Is Part Of: Orbit. Volume 36:Number 1(2017)
• Page Start: 13
• Page End: 18
• Publication Date: 2017-01-02
• Subjects: 20G silicone rod -- annular stent -- canalicular laceration -- Mini-Monoka; Eye-sockets -- Surgery -- Periodicals; Eye-sockets -- Diseases -- Periodicals; Orbit -- surgery -- Periodicals; Orbital Diseases -- Periodicals; 617.7
• DOI: 10.1080/01676830.2017.1279646
• Languages: English
• ISSNs: 0167-6830

Abstract

ABSTRACT: To determine the factors predictive of outcome in canalicular laceration repair at a tertiary eye care centre. A retrospective review of the medical records of all primary canalicular laceration repairs managed at a tertiary eye care centre between the years 2006 and 2014 was done. Thirty-nine patients were included and majority were male (79.5%) with a mean age of 30.05 + 16.2 years (range 2–65). Most ( n = 34) had monocanalicular laceration and 5 had bicanalicular laceration. All surgeries were done in the operating room setting. Overall patency by irrigation was seen in 74.4% at a median follow-up of 19.89 weeks (range 21–910). Anatomical outcome was different among the stents and best after Mini-Monoka monocanalicular stent (17/19; 89.5%) followed by bicanalicular annular stents ( n = 6; 60%) and 20G Silicone rod (8/14, 57%). The factors predictive of poor outcome were related to the mode of injury [road traffic accidents; Hazard ratio (HR)19.57; p = 0.048] and the type of stent [20G silicone rod (HR 35.7; C.I 3.04 - 419.14; p = 0.004)] by multivariate analysis. Skill of the surgeon was critical as the outcome for fellows-in-training showed a trend towards failure (HR 6.66, p = 0.07). Complications included stent extrusion ( n = 28.2%), punctal granuloma ( n = 5.1%) and stent exposure ( n = 2.5%). The mode of injury - road traffic accidents and type of stent - 20 G silicone rod were risk factors predictive of poorer outcome after canalicular laceration repair. Individual skill of operating surgeon may be a critical factor suggesting a review of training protocols.