Factors affecting the Anatomical and Functional Success rate in Canalicular Laceration Repair

Purpose: To evaluate the factors determining the anatomical and functional results in primary canalicular laceration repair Methods: In this observational study, we reviewed the medical records of all cases underwent primary canalicular laceration repair in a tertiary hospital between 2016 and 2018. All cases were repaired by monocalanicular stent(Minimonoka). Anatomical and functional patency were assessed by the presence of epiphora, lacrimal system irrigation, dye disappearance test and scintigraphy. The effect of demographic characteristics, causes of canaliculum laceration, accompanying orbital injuries, anatomical location of laceration, and time of repair were evaluated.Results: Out of 210 eyelid laceration, 40 cases (82% male) with mean age of 33 ±17 years (ranged, 4-77) with canalicular laceration were included in the study. The causes of injury were car accident (45%), occupational injury (20%), quarrel (20%) and others (15%). Laceration of the distal part of canaliculum occurred in 75% and the proximal part in 25%. Lower canaliculum was involved in 65% of the cases and bicanalicular injury in 18%. Eighty percent of the cases were repaired in less than 48 hours from the injury. Anatomical patency, confirmed by irrigation test, was achieved in 93%. Epiphora improved in 75%. Multivariate analysis demonstrated that laceration of distal part had lower success rate (P<0.05). The lower success rate was also seen in cases with repair after 48 hours (P<0.05). Symptoms and dye disappearance test were relatively abnormal in lower canaliculi laceration, complex injuries and delayed operation time. Conclusion: Our results showed that the primary canalicular laceration repair using monocanalicular stent havean overall excellent anatomical success rate. Proximity of laceration and early repair may improve the outcome. Distal laceration location, lower canaliculi laceration and accompanying orbital injuries could deteriorate the functional success rate.