A new method for identifying the cut ends in canalicular laceration

Area of Science:

• Ophthalmology
• Surgical Techniques
• Lacrimal System Anatomy

Background:

• Locating proximal and distal cut ends of the canaliculus is a critical challenge in canalicular repair.
• Complex acute and late-presenting canalicular lacerations pose significant difficulties for surgeons.
• Traditional methods like irrigation and air injection have limitations in identifying severed canaliculus ends.

Purpose of the Study:

• To introduce and evaluate a novel fiber optic light pipe technique for identifying cut ends of the canaliculus.
• To assess the efficacy and safety of this light-guided method in canalicular reconstruction.
• To determine the time efficiency of the new technique compared to existing methods.

Main Methods:

• A 23-gauge fiber optic light pipe was utilized to identify the cut ends of the lacerated canaliculus.
• The identified cut ends were then intubated with silicone tubes for lacrimal system reconstruction.
• The technique was applied to 33 cases of both acute and late-presenting canalicular lacerations.

Main Results:

• Successful identification of cut ends was achieved in all 33 cases using the light-guided technique.
• The mean time from identification to silicone tube insertion was 5 minutes.
• No complications were reported during or after the procedure in any of the cases.

Conclusions:

• The novel fiber optic light pipe technique provides an effective and efficient method for locating cut ends of the canaliculus.
• This light-guided approach simplifies the surgical repair of canalicular lacerations, including complex and late presentations.
• The technique offers a promising improvement for canalicular reconstruction, reducing operative time and avoiding complications.