ASOPRSFall Scientific SymposiumSyllabus
98
9:30 – 10 am
BreakwithExhibitors andPoster StandBy Session
Lacrimal Session
Moderator: JohnD. Ng,MD,MS, FACS
10:00 am
Surgical andEpidemiologic FactorsAffectingCanalicular LacerationRepair with
theMiniMonokaMonocanalicular Stent
Blair Armstrong
1
,Michael Rabinowitz
2
, BriannaKenney
3
, Robert Penne
2
.
1
OphthalmologyResidency,Wills EyeHospital, Philadelphia,
PA, UnitedStates,
2
Oculoplastic andOrbital SurgeryService,Wills EyeHospital, Philadelphia, PA, UnitedStates,
3
Department of
Research,Wills EyeHospital, Philadelphia, PA, UnitedStates
Introduction:
The purpose of this study is to review the epidemiologic and clinical characteristics of canalicular involving eyelid
lacerations surgically reconstructedwith theMini Monokamonocanalicular stent (FCI Ophthalmics, France) to identify individual and
surgical factors leading to complications or poor outcomes.
Methods:
Retrospective analysiswith survey component. Patientswere identified through emergency department discharge log and
electronic billing records. Paper chartswere reviewed for demographic data, injury details, operative report, and visit information.
All patientswere contacted via telephone survey.Variableswere quantified usingmeans,medians, standard deviation, and ranges
for continuous variables and frequencies and percentages for categorical variables.All analysiswas performed using SAS9.3 (SAS
Institute, Cary, NC).
Results:
95 canalicular lacerations in 89 patientswere identified. 18 patients responded to the telephone survey and 28 (31.5%)
of patients did not maintain follow up appointments.Themean agewas 34.6 (range 0-91 years). 69.4% of patientsweremale and
30.6%were female; 51.5%were Caucasian, 30.9%Black, 14.7%Hispanic, and 2.9%Asian. Canalicular lacerationsweremost
commonly caused by blunt accidental trauma (31.3%), animal bite (22.5%), or sharp accidental trauma (16.3%). Lower lid (60.7%)
wasmore often affected than upper (32.1%) or both lids (7.1%).Associated ocular injuries included non-canalicular eyelid lacerations
(n=19), hyphema (n=16), and ruptured globe (n=4).
72.3% of patients underwent canalicular repair in the operating room under general anesthesia and 27.7% in aminor procedure
roomwith local anesthesia. 27.3% underwent repair <12 hours from sustaining injury, 36.4%within 12-24 hours, 24.2% at 25-48
hours, and 10.6% at greater than 48 hours. Stentswere removed at amean value of 21.77weeks (range: 6 -152). 57.1% did not
have documented stent removal at last follow up visit.
Complications included early extrusion (n=15 patients) and infection (n=4 patients). Outcomemeasures included presence of tearing
(31.7%) or absence (68.3%).Tearing and epiphoraweremore common in patientswith>24 hours between injury and repair (p=
0.029).Therewas a higher incidence of tearing in patients sustaining lower lid canalicular lacerations (p=0.024).
Conclusions:
Canalicular lacerations aremost common in youngmales and often secondary to blunt or sharp accidental trauma.
Delayed repair and lacerations involving the lower lid result in higher incidence of tearing and epiphora.
DetailedProgram
—Friday,October 17, 2014
