Canalicular reperation results in our clinic

Purpose: To evaluate the functional and the anatomical success in patients who were underwent unilateral traumatic laceration repair surgery in our eye clinic. Material and methods: Consecutive patients who presented to Dicle University Faculty of Medicine Hospital Opthalmology Service and had canalicular repair by the same surgeon between September 2013 and March 2017 were included. Patient's demographic datas, cause and the time of surgery, surgical method, follow up time recorded. Postoperative epiphora was evaluated by fluorescite dissapear test and patients were asked if they had any trouble with epiphora, by the way fonctional success was evaluated. The patency of the lacrimal system was examined by canalicular irrigation and probing. Results: The mean age of the cases was 14,7 ± 2,6 years (range 1-68 years). Forty two patients was included in the study (31 male, 11 female). The indirect-avulsive injury was observed in 57 % (n=24) and the direct-penetran injury was observed in 43 % (n=18). The distribution of injured eyes and canalicules was as follows: Right eye 47,6 % (n=20), left eye 52,4 % (n=22), inferior canalicule 69 % (n=29), superior canalicule right 26,2 % (n=11), bicanalicular laceration 4,8 % (n=2) and left inferior canalicule 35,7 % (n=15) was the most injured canalicule through them. When traumatic etiology of lacrimal canalicular lacerations was evaluated, it was observed that 14 of them were injured after violent events (assault, fight, body contact injury) and that was the most common etiological cause. Eleven patients were injured after sharp objects injury (knife, caple, glass bottle, toys), 10 patients were injured after falling events, 5 patients were injured after animal bite and scratching and 2 cases after other injuries. The average time from the trauma to the surgery was 13,6 ± 1,1 hours (range: 4-30 hours). The mean duration of the silicone tube materyal left in the lacrimal canaliculus was determined as 156 ± 6,8 days (range: 20 to 240 days). The average follow up time was 15,52 ± 1,5 months (range: 6 to 36 months). There was no ocular pathology accompanied in the 50 % (n=21) of the study population, 26,2 (n=11) of the cases had more than 1 cm of eyelid laceration, 7,1 % (n=3) had subconjunctival hemorrhage, 7,1 % (n=3) had hyphema, 2,4 % (n=1) had corneal epithelial defect and in 7,1 % (n=3) the other (subconjonctival foreign body pentration, conjonctival laceration) associated ocular pathologies were detected. Surgery was performed under general anesthesia for 40 patients (95,2 %), and under local anesthesia for 2 patients (4,8 %). In 25 patients (59,5 %) annular silicon tube intubation procedure was performed in 13 patients (31 %) Mini Monoka stenting was performed and 4 patients (14,3 %) were treated with bicanalicular nasal intubation procedure. Anatomic success was achieved in 90,2 % (n=38) of the cases despite 9,5 % (n=4) of them did not have anatomic success. Functional success was achieved in 85,7 % (n=36) of the patient, despite 14,3 (n=6) of them did not have functional success. No post operative complications were observed in 32 of the patients. Beside this, various post operative complications were observed in 10 patients and additional surgical prosedures were applied to 2 of them. Conclusion: When the results of anatomical and functional success were compared, there were no statistically significant differences between the surgical groups. It was considered that there were no statistical differences; because of the small number of patients. When the success rates were evaluated, similar success rates were found in anular silicone tube intubation and Mini Monoka implant groups. Whereas bicanalicular nasal silicone tube intubation group's success rates were lower than the other groups. Larger group of casses were required in order to reach statistically significant difference.