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Management outcomes of canalicular laceration in children
Fatimah Alhammad1,2, Alicia Galindo-Ferreiro3, Rajiv Khandekar1
1Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Insights
Pediatric canalicular lacerations are common in boys, often caused by sharp objects. Both monocanalicular and bicanalicular stents showed similar success rates for repair.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Trauma Surgery
Background:
- Canalicular lacerations are injuries to the tear drainage system.
- Pediatric cases present unique challenges in diagnosis and management.
- Understanding epidemiological patterns is crucial for targeted prevention and treatment.
Purpose of the Study:
- To analyze epidemiological data, clinical characteristics, management strategies, and outcomes of pediatric canalicular lacerations.
- To evaluate the effectiveness of different surgical approaches in a tertiary eye care setting.
- To identify common causes and affected anatomical locations in children.
Main Methods:
- Retrospective analysis of 43 pediatric patients undergoing canalicular laceration repair over 15 years.
- Data collected included demographics, injury etiology, trauma type, and surgical technique.
- Success defined by absence of epiphora and negative dye disappearance test (DDT).
Main Results:
- The study included 43 pediatric patients (median age 6.35 years), with males predominating (69.8%).
- Sharp objects, particularly metallic clothing hangers, were the leading cause (46.5%).
- Lower canaliculus involvement was most frequent (65.1%); bicanalicular and monocanalicular stents showed comparable success rates (87.5% functional success).
Conclusions:
- Canalicular lacerations are prevalent in male children, predominantly affecting the lower canaliculus.
- No significant difference in repair success was observed between monocanalicular and bicanalicular stents.
- Highlighting common causes in public health education may help reduce incidence.
Purpose:
To report the epidemiological data, clinical profile, management, and outcomes of canalicular lacerations in the pediatric age group in a tertiary eye care hospital in Saudi Arabia.
Methods:
This retrospective study evaluated pediatric patients who underwent canalicular laceration repair in the last 15 years at King Khalid Eye Specialist Hospital (KKESH), Saudi Arabia. Demographics, causes of injury, type of trauma, surgical approach, and outcomes were analyzed. The success of repair was defined as the absence of epiphora after canaliculus repair with negative dye disappearance test (DDT). Success within subgroups was compared. P < 0.05 was considered statistically significant.
Results:
The study sample was comprised of 43 patients, with a median age of 6.35 years (range, 1.77-17.96 years). Most of the patients were males (69.8%). Sharp objects were the most common cause of canalicular laceration (46.5%), being 9 (20.9 %) caused by a metallic clothing hanger. Lower canaliculus was involved in 65.1%, upper canaliculus in 32.6%, and both canaliculi in 2.3% of patients. Canaliculus repair was performed with a bicanalicular stent in 58.1 % and monocanalicular stent in 41.9 % of patients.The success rate and risk of complications using bicanalicular or monocanalicular stent did not differ (P = 0.065). Functional success was achieved in 87.5% of patients.
Conclusion:
Canalicular laceration is common in male children, mainly affecting the lower canaliculus. There was no difference in success rate between monocanalicular and bicanalicular stent. As canalicular laceration could be related to social determinants, the main causes should be highlighted in community health education initiatives.
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