National survey on the management of lacrimal canalicular injury in the United Kingdom.
OBJECTIVE
The management of lacrimal canalicular injury is controversial. It is believed that practice varies widely among surgeons.


METHODS
One hundred and twenty National Health Service-based Consultant Ophthalmologists with oculoplastic interest across the United Kingdom (UK) were identified via the website http://www.specialistinfo.com, which is a website that asks UK consultants to identify their areas of subspecialty interests. Questionnaires were sent out to them to determine caseload, intraoperative techniques (magnification, suture and stents) and postoperative management (antibiotic use, stent placement and replacement and secondary lacrimal surgery) of patients with canalicular injuries.


RESULTS
Eighty-nine (74%) completed questionnaires were returned and analysed. Most (63%) of the respondents treated between one and five canalicular injuries over the past year. Thirty-eight (43%) of them would repair a monocanalicular injury only if the lower canaliculus was involved and 36 (40%) respondents would always repair a monocanalicular injury. Eighty-two (92%) respondents used magnification during surgery. Fifty-one (57%) respondents would never consider using the pigtail probe. Eighty-five (96%) would use the bubble test and/or fluorescein dye to locate the severed medial canalicular end. Vicryl or dexon was the suture of choice for 76 (85%) and 63 (71%) respondents for repairing pericanalicular and canalicular tissues, respectively. Thirteen (14.6%) respondents did not stent their canalicular repairs. Forty-seven (53%) routinely used prophylactic antibiotics. Sixty-eight (76%) respondents would wait between 3 and 12 months before undertaking further lacrimal surgery.


CONCLUSIONS
This study confirmed that management of lacrimal canalicular injury varies widely among surgeons in the UK.
Ho
Thomas
T
Central Eye Department, Central Middlesex Hospital, Acton Lane, Park Royal, London NW10 7NS, UK.
Lee
Vickie
V
D005131:Eye Injuries / Q000601:surgery*; D019793:Fluorescein; D006306:Health Surveys; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D007765:Lacrimal Apparatus / Q000293:injuries*; D009313:National Health Programs / Q000706:statistics & numerical data*; D013508:Ophthalmologic Surgical Procedures / Q000706:statistics & numerical data*; D011182:Postoperative Care / Q000379:methods; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015607:Stents; D011795:Surveys and Questionnaires; D013536:Suture Techniques; D013537:Sutures; D006113:United Kingdom
D019793:Fluorescein