title: Canalicular lacerations: Factors predicting outcome at a tertiary eye care centre.
abstract: To determine the factors predictive of outcome in canalicular laceration repair at a tertiary eye care centre. A retrospective review of the medical records of all primary canalicular laceration repairs managed at a tertiary eye care centre between the years 2006 and 2014 was done. Thirty-nine patients were included and majority were male (79.5%) with a mean age of 30.05 + 16.2 years (range 2-65). Most (n = 34) had monocanalicular laceration and 5 had bicanalicular laceration. All surgeries were done in the operating room setting. Overall patency by irrigation was seen in 74.4% at a median follow-up of 19.89 weeks (range 21-910). Anatomical outcome was different among the stents and best after Mini-Monoka monocanalicular stent (17/19; 89.5%) followed by bicanalicular annular stents (n = 6; 60%) and 20G Silicone rod (8/14, 57%). The factors predictive of poor outcome were related to the mode of injury [road traffic accidents; Hazard ratio (HR)19.57; p = 0.048] and the type of stent [20G silicone rod (HR 35.7; C.I 3.04 - 419.14; p = 0.004)] by multivariate analysis. Skill of the surgeon was critical as the outcome for fellows-in-training showed a trend towards failure (HR 6.66, p = 0.07). Complications included stent extrusion (n = 28.2%), punctal granuloma (n = 5.1%) and stent exposure (n = 2.5%). The mode of injury - road traffic accidents and type of stent - 20 G silicone rod were risk factors predictive of poorer outcome after canalicular laceration repair. Individual skill of operating surgeon may be a critical factor suggesting a review of training protocols.
authors.affiliation: a Ophthalmic Plastic and Reconstructive Surgery, Orbit and Ocular Oncology , LV Prasad Eye Institute , Sri Munsi Tulsi Chanrai Campus, Bhubaneswar, India.
authors.forename: Swati
authors.initials: S
authors.lastname: Singh
authors.affiliation: b Ophthalmic Plastic and Reconstructive Surgery, Orbit and Ocular Oncology, LV Prasad Eye Institute, Kode Venkatadri Chowdary Campus , Vijayawada , India.
authors.forename: Anasua
authors.initials: A
authors.lastname: Ganguly
authors.affiliation: a Ophthalmic Plastic and Reconstructive Surgery, Orbit and Ocular Oncology , LV Prasad Eye Institute , Sri Munsi Tulsi Chanrai Campus, Bhubaneswar, India.
authors.forename: Apurva
authors.initials: A
authors.lastname: Hardas
authors.affiliation: a Ophthalmic Plastic and Reconstructive Surgery, Orbit and Ocular Oncology , LV Prasad Eye Institute , Sri Munsi Tulsi Chanrai Campus, Bhubaneswar, India.
authors.forename: Devjyoti
authors.initials: D
authors.lastname: Tripathy
authors.affiliation: a Ophthalmic Plastic and Reconstructive Surgery, Orbit and Ocular Oncology , LV Prasad Eye Institute , Sri Munsi Tulsi Chanrai Campus, Bhubaneswar, India.
authors.forename: Suryasnata
authors.initials: S
authors.lastname: Rath
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005131:Eye Injuries / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D022125:Lacerations / Q000175:diagnosis / Q000601:surgery*; D007765:Lacrimal Apparatus / Q000293:injuries*; D007766:Lacrimal Apparatus Diseases / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D009885:Ophthalmology; D012189:Retrospective Studies; D015607:Stents; D062606:Tertiary Care Centers; D007507:Therapeutic Irrigation; D016896:Treatment Outcome
keywords: 20G silicone rod; Mini-Monoka; annular stent; canalicular laceration