Canalicular laceration: A 10-year epidemiologic and clinical study in Taiwan

The purpose of this study was to examine the epidemiologic and clinical characteristics of patients with canalicular laceration who underwent surgical repair, and the long-term outcome. We retrospectively reviewed the medical records of 106 patients with canalicular lacerations which were repaired with bicanalicular-nasal silicone intubation at Chang Gung Memorial Hospital, Taipei, Taiwan from 1984 to 1993. Most injuries occurred in young adults and children with a medium age of 34.0 years. Traffic accident (34.0%) was the most common cause of injury followed by body contacts and rod trauma. Dog bite was the most common cause of injury among children. The lower canaliculus was involved in 77 (72.6%) patients, the upper in 18 (17.0%), and both upper and lower in 11 (10.4%). The mean duration between injury and surgical repair was 2.08 days. Early repair was associated with a better result (p<0.001). Stents were retained for a mean duration of 5.4 months. The irrigation patency rate was 85.5%. The incidence of postoperative epiphora was 30.8% and 19.0% in patients with upper and lower canalicular injury, respectively. Patients with combined upper and lower canalicular lacerations had a higher incidence of postoperative epiphora than those with single canalicular lacerations (p< 0.01). Traffic accident was the major cause of canalicular laceration in our series, which is different from the findings in the western world. The upper canaliculus plays an equal role with the lower canaliculus in lacrimal drainage. Early primary anastomosis with the use of a stent in the lumen of the canaliculus can yield good results.