Han Shaolei, Wang Tingting, Jia Jinchen, Sun Suhuan, Fan Yiming
Department of Ocular Trauma, Hebei Eye Hospital, Hebei Provincial Key Laboratory of Ophthalmology, Xingtai, China.
J Craniofac Surg. 2019 Oct;30(7):2261-2264. doi: 10.1097/SCS.0000000000005990.
Bicanalicular lacerations are relatively rare and more of a surgical challenge in clinical practice. The purpose of this study is to evaluate the clinical characteristics and surgical outcomes of bicanalicular lacerations with a new bicanalicular silicone stent at a tertiary eye care center.
All patients who underwent bicanalicular lacerations repair from January 2013 and December 2018 were retrospectively reviewed. Data collected for each patient included patient demographics, affected sides, cause of injuries, the timing of management, associated ocular injuries, the timing of stent removal, duration of follow-up and the outcomes of the surgical repair with a new bicanalicular silicone stent.
Thirty-six patients with bicanalicular lacerations met the inclusion criteria and were enrolled in the study. The mean age of the patients was 43.8 years old (range: 2-73years). Of the 36 patients, 33 (91.7%) were males and 3 (8.3%) were females. The right eye was injured in 17 patients (47.2%). All patients underwent surgical intervention within 24 hours. The most common cause of bicanalicular lacerations was electric bicycles accidents (7 patients, 19.4%), and followed by motor vehicle accidents (6 patients, 16.7%), blunt objects (6 patients, 16.7%), fights (6 patients, 16.7%), falls (3 patients, 12%), dog bites (2 patients, 5.6%), hook injuries (2 patients, 5.6%), broken glass (2 patients, 5.6%), and sharp objects (2 patients, 5.6%). The most common associated ocular injuries were orbital fracture (61.1%), followed by lid lacerations and open globe injuries. The functional success rate was 86.1%. The average interval between the surgery and the stent removal was 13.8 weeks (range: 8-20 weeks). All the stents were removed successfully without any difficulty in the outpatient department. The follow-up after stent removal ranged from 2 to 12 months (mean: 5.1months).
Bicanalicular lacerations involvement occured in 6.8% of all canalicular lacerations. The most common cause of bicanalicular lacerations was electric bicycles accidents and the most common associated ocular injuries was orbital fracture in North China. The new bicanalicular silicone stent achieved good functional success (86.1%) in the management of bicanalicular lacerations.
双泪小管撕裂伤相对少见，在临床实践中更具手术挑战性。本研究旨在评估在一家三级眼科护理中心使用新型双泪小管硅胶支架治疗双泪小管撕裂伤的临床特征和手术效果。
回顾性分析2013年1月至2018年12月期间所有接受双泪小管撕裂伤修复手术的患者。收集的每位患者的数据包括患者人口统计学资料、患侧、受伤原因、处理时间、相关眼部损伤、支架取出时间、随访时长以及使用新型双泪小管硅胶支架进行手术修复的效果。
36例双泪小管撕裂伤患者符合纳入标准并纳入本研究。患者的平均年龄为43.8岁（范围：2 - 73岁）。36例患者中，33例（91.7%）为男性，3例（8.3%）为女性。17例患者（47.2%）右眼受伤。所有患者均在24小时内接受了手术干预。双泪小管撕裂伤最常见的原因是电动自行车事故（7例，19.4%），其次是机动车事故（6例，16.7%）、钝器伤（6例，16.7%）、打架（6例，16.7%）、跌倒（3例，12%）、狗咬伤（2例，5.6%）、鱼钩伤（2例，5.6%）、碎玻璃伤（2例，5.6%）和锐器伤（2例，5.6%）。最常见的相关眼部损伤是眼眶骨折（61.1%），其次是眼睑撕裂伤和开放性眼球损伤。功能成功率为86.1%。手术与支架取出之间的平均间隔为13.8周（范围：8 - 20周）。所有支架均在门诊成功取出，无任何困难。支架取出后的随访时间为2至12个月（平均：5.1个月）。
双泪小管撕裂伤占所有泪小管撕裂伤的6.8%。在华北地区，双泪小管撕裂伤最常见的原因是电动自行车事故，最常见的相关眼部损伤是眼眶骨折。新型双泪小管硅胶支架在双泪小管撕裂伤的治疗中取得了良好的功能成功率（86.1%）。
