Canalicular laceration repair: an analysis of variables affecting success

To evaluate the outcomes of all canalicular lacerations at a high-volume urban tertiary eye care center and calculate the impact of variables of repair on success.

A retrospective review over a 10-year span of all primary canalicular laceration repairs was performed. Variables included patient demographics, repair setting, surgeon level of training, mechanism of injury, associated injuries, type of stent used, and success of repair.

One hundred thirty-seven patients met the inclusion criteria and were used for analysis. The mechanism of injury was primarily due to altercations (31.4%), followed by accidents (21.9%). Most repairs were performed in the operating room (72.3%) with an overall success rate of 85.9% compared with 36.8% in the minor procedure room. The success rate varied significantly by level of training, with a fellowship-trained oculoplastic surgery attending physician attaining the highest success rate of 84.0%. The success by primary surgeon training level was statistically significant (p<0.0001). The efficacy of a monocanalicular stent was also studied and was not significantly different from bicanalicular stenting when other variables were accounted for (p=0.1186).

The overall success of canalicular laceration repair is good. However, the setting of repair and level of training greatly affect the success of repair. In a tertiary care setting, an attending surgeon with subspecialty training in oculoplastic surgery should participate in the canalicular laceration repair to maximize the success rate. Performing the repair in the operating room rather than a minor procedure room setting may further improve the patient outcomes.