title: Two-step retrograde closed stenting: a novel method for treating canalicular lacerations in Chinese patients.
abstract: OBJECTIVE
  To evaluate the efficacy of two-step retrograde closed stenting for treating canalicular laceration. methods: Forty-eight consecutive canalicular laceration cases (48 eyes) were randomised and divided into two groups: a one-step group and a two-step group. In the two-step group (23 cases), the first step was performed in the outpatient department and included identifying the medial cut end of the canaliculus and probing under a slit-lamp microscope, followed by a retrograde canalicular stenting assisted by a memory titanium stylet. The second step was canalicular anastomosis, which was performed in the operating room. In the one-step group (25 cases), all of the surgical procedures were performed when preoperative preparations were simultaneously available.
  
  
  RESULTS
  The time elapsed from the doctor visit to the treatment was 4.3 ± 2.4 h in the two-step group and 18.8 ± 6.3 h in the one-step group (P<0.01). The canalicular medial cut ends were found in all cases, but 8.6 ± 3.5 min was needed in the two-step group, and 51.4 ± 24.2 min was needed in the one-step group (P<0.01). The numerical rating scale for pain during surgery was 1.8 ± 1.2 in the two-step group and 5.4 ± 2.2 in the one-step group (P<0.01). One case (2.63%) in the two-step group and nine cases (36%) in the one-step group required other assisted methods to locate the medial cut end (P=0.007). Twenty-one cases (91.3%) in the two-step group and 20 cases (80%) in the one-step group achieved patent lacrimal drainage systems during a 12-month follow-up (P=0.528).
  
  
  CONCLUSIONS
  The two-step canalicular anastomosis method allows an early search for the medial cut end of the canaliculus and improves the chances of finding it; it is also a quicker, less invasive method for treating canalicular lacerations.
authors: 1] Department of Ophthalmology, Tongji Hospital affiliated with Tongji University School of Medicine, Shanghai, China [2] Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany.
authors: Y
authors: Y
authors: Bi
authors: G
authors: G
authors: Sui
authors: Q
authors: Q
authors: Zhou
authors: L M
authors: LM
authors: Heindl
authors: F
authors: F
authors: Bock
authors: X
authors: X
authors: Sun
authors: S
authors: S
authors: Tang
authors: Z
authors: Z
authors: Wang
authors: C
authors: C
authors: Cursiefen
mesh_terms: D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D044466:Asian People; D002681:China; D005143:Eyelids / Q000293:injuries* / Q000601:surgery; D005260:Female; D006801:Humans; D022125:Lacerations / Q000601:surgery*; D007765:Lacrimal Apparatus / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009666:Nose / Q000601:surgery; D015607:Stents; D061665:Time-to-Treatment; D055815:Young Adult
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