Management of canalicular lacerations: epidemiological aspects and experience with Mini-Monoka monocanalicular stent.
OBJECTIVE
To report the epidemiological data, clinical profile, and surgical outcome of canalicular lacerations in an Indian population.


METHODS
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.


CONCLUSIONS
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.
Division of Ophthalmic Plastic Surgery, LV Prasad Eye Institute, LV Prasad Marg, Banjara Hills, Hyderabad, India. milind@lvpei.org
Milind N
MN
Naik
Anagha
A
Kelapure
Suryasnata
S
Rath
Santosh G
SG
Honavar
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005131:Eye Injuries / Q000453:epidemiology* / Q000601:surgery*; D005143:Eyelids / Q000293:injuries*; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007440:Intubation / Q000295:instrumentation; D022125:Lacerations / Q000453:epidemiology* / Q000601:surgery*; D007765:Lacrimal Apparatus / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents