Naik Milind N, Kelapure Anagha, Rath Suryasnata, Honavar Santosh G
Division of Ophthalmic Plastic Surgery, LV Prasad Eye Institute, LV Prasad Marg, Banjara Hills, Hyderabad, India.
Am J Ophthalmol. 2008 Feb;145(2):375-380. doi: 10.1016/j.ajo.2007.09.018. Epub 2007 Dec 3.
To report the epidemiological data, clinical profile, and surgical outcome of canalicular lacerations in an Indian population.
Retrospective interventional case series.
All patients who underwent canalicular laceration repair from July 1, 2002 to June 30, 2005 at a tertiary eye care center were retrospectively reviewed. Demographics, cause of eyelid injury, associated ocular injury, surgical management with Mini-Monoka monocanalicular stent, and its outcome were analyzed.
Sixty-six patients underwent eyelid laceration repair, of which 24 (36%) had involvement of the canalicular system. The mean age at presentation was 16 years (range, 10 months to 52 years); 20 (83.3%) patients were males. Mode of injury included the blouse-hook fastener in five (20.8%) breast-feeding infants, bicycle handle injury in four (16.7%) children, and metal rod injury in five (20.8%) adults. Lower canaliculus was involved in 13 (54.1%), upper in eight (33.3%), and both in three (12.5%) patients. Simultaneous globe injury was noted in six (25%) patients, five (83.3%) of which had upper canalicular involvement. Twenty-seven canalicular lacerations (24 patients) underwent stenting with the Mini-Monoka monocanalicular stent. Three (11.1%) stents extruded within one month. At the final follow-up (mean, 18.5 months), canalicular block was noted in two (10%) out of 20 patients; none had epiphora.
Canalicular involvement occurs in 36% of eyelid injuries. Injury by the "blouse-hook fastener" is unique to infants in the Indian context. Simultaneous globe injury is present in 25% of cases, especially when the upper canaliculus is involved. Mini-Monoka stent extrusions occur within one month. With an 11.1% extrusion rate, Mini-Monoka stents achieved good anatomical (90%) and functional (100%) success in the management of canalicular injury.
报告印度人群泪小管撕裂伤的流行病学数据、临床特征及手术结果。
回顾性干预病例系列研究。
对2002年7月1日至2005年6月30日在一家三级眼科护理中心接受泪小管撕裂伤修复手术的所有患者进行回顾性研究。分析患者的人口统计学资料、眼睑损伤原因、相关眼外伤情况、使用Mini-Monoka单泪小管支架的手术治疗方法及其结果。
66例患者接受了眼睑撕裂伤修复手术,其中24例(36%)累及泪小管系统。就诊时的平均年龄为16岁(范围10个月至52岁);20例(83.3%)为男性。损伤方式包括:5例(20.8%)母乳喂养婴儿被胸罩搭扣致伤,4例(16.7%)儿童被自行车把手致伤,5例(20.8%)成人被金属棒致伤。13例(54.1%)患者下泪小管受累,8例(33.3%)上泪小管受累,3例(12.5%)上下泪小管均受累。6例(25%)患者同时存在眼球损伤,其中5例(83.3%)上泪小管受累。27例泪小管撕裂伤(24例患者)采用Mini-Monoka单泪小管支架置入术。3例(11.1%)支架在1个月内脱出。在最后一次随访时(平均18.5个月),20例患者中有2例(10%)出现泪小管阻塞;无一例患者有溢泪症状。
36%的眼睑损伤累及泪小管。在印度,“胸罩搭扣”致伤是婴儿特有的损伤类型。25%的病例同时存在眼球损伤,尤其是当上泪小管受累时。Mini-Monoka支架脱出发生在1个月内。Mini-Monoka支架脱出率为11.1%,在泪小管损伤治疗中取得了良好的解剖学成功率(90%)和功能成功率(100%)。