Original Article

Surgical Treatment in Canalicular Injuries: When and How To Apply ? - Original Article

  • Dilek Yüksel
  • Nilay Dündar
  • Deniz Basman
  • Remzi Kasim
  • Sunay Duman

Turk J Ophthalmol 2007;37(5):-

Objective: To present the surgical techniques we used for treating lacrimal duct injuries and evaluate the efficiency and discuss the indications for surgery. Material Methods: Twenty-two patients with lacrimal duct injuries between 2000 and 2005 ( ages between 7 and 62 years ) were studied. In 14 cases inferior canalicular, in 6 cases superior canalicular and in 2 cases combined inferior and superior canalicular injuries were diagnosed. Surgery was performed in 3 hours to 1 week after trauma. In 17 patients repairment was performed by bicanalicular annular intubation, 2 patients were repaired with bicanalicular nasolacrimal intubation and 3 cases were repaired with monocanaliculer nasolacrimal intubation. Silicon tubes were removed after 2-6 months ( mean 5.3 months ). All cases were followed up for 4 – 24 months ( mean 14.9 months ). Results: In 17 cases ( %77.2 ) anatomic success were achieved and in these cases the canalicular lumen was seen in both sides of the injury and microsurgical canalicular anastomosis applied. In 5 cases anatomical success could not be achieved. In these cases, injuries were in medial of inferior canalicula therefore lumen could not be clearly seen and microsurgical anastomosis could not be applied. Despite lack of anatomical success epiphora had disappeared in three of these five cases. Conclusion: We suggest that microsurgical canalicular anastomosis technique offers reliable results for mucosal entirety. In monocanalicular injuries which microsurgical anastomosis could not be performed, avoiding surgery would be more convenient.

Keywords: Canalicular laceration, lacrimal stents, eyelid trauma, silicone intubation, tear drainage.