Purpose: To evaluate the etiology of lacrimal canalicular lacerations and explore possible risk factors influencing prognosis.
Methods: A total of 142 patients (142 eyes) with lacrimal canalicular lacerations were reviewed and surgically repaired between March 2017 and March 2018. The analyzed data contained demographic information, the type of trauma, injury locations, associated additional ocular injuries and surgerical outcomes at follow-up. The main outcome measures were anatomic success, functional success, and the complication of surgery.
Results: The mean patient age was 42.07years(ranging from 1-75 years) and 112 (78.87%) were men. Upper and lower canalicular lacerations were found in 14 (9.86%) and 112 patients (78.87%), respectively. Electromobile accidents were the leading cause of injury with 76 patients (53.52%). There were 100 (70.42%) patients who had lid laceration without tarsal plate fracture and 42 (29.58%) patients who had lid laceration with tarsal plate fracture. Functional reconstruction failure rates were higher in patients with indirect injuries, lid laceration with tarsal plate fracture, and with laceration punctum crack( P <0.05). Surgical Complications were detected in the form of lacrimal punctum ectropion in 3 (2.11%) patients, lacrimal punctum crack in 2 (1.41%) patients, stent extrusion and loss in 2 (1.41%) patients.
Conclusions: Electromobile accidents have become the leading cause of injury instead of the motor vehicle accidents because of changes in lifestyle. Silicone intubation was most commonly used in surgery with high anatomic success. The indirect injuries, lid laceration with tarsal plate fracture and with lacrimal punctum crack, were significantly more likely to lead to a poor prognosis, as comfirmed by the lower functional success rate of surgery.
Keywords: Canalicular lacerations; etiology; prognosis; epiphora; silicone tube intubation