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Pediatric Eyelid and Canalicular Lacerations: Epidemiology and Outcomes
Insights
Eyelid lacerations from dog bites or falls often involve the eyelid margin or tear drainage system (canalicular involvement). While most complications are minor, specific injuries increase risks, necessitating close follow-up.
Area of Science:
- Ophthalmology
- Trauma Surgery
- Pediatric Surgery
Background:
- Eyelid lacerations are common injuries in children.
- Understanding risk factors for canalicular involvement and postoperative complications is crucial for effective management.
Purpose of the Study:
- To analyze the epidemiology of pediatric eyelid lacerations.
- To identify predictors of tear drainage system (canalicular) involvement.
- To describe the incidence and types of postoperative complications following surgical repair.
Main Methods:
- Retrospective chart review of 165 pediatric patients undergoing eyelid laceration repair at a level I trauma center.
- Analysis of patient and surgical characteristics.
- Univariate and multivariate logistic regression to identify risk factors for canalicular involvement and complications.
Main Results:
- Dog bites (38%) and falls (20%) were leading injury mechanisms.
- Eyelid margin (65%) and canalicular (47%) involvement were frequent.
- Risk factors for canalicular involvement included hook-related injury, eyelid margin involvement, and lower eyelid injury.
- Postoperative complications occurred in 24% of patients, most commonly ptosis and stent issues.
Conclusions:
- Hook-related injury, eyelid margin involvement, and lower eyelid injury predict canalicular involvement.
- Postoperative complications are generally minor and not linked to perioperative factors.
- Vigilant postoperative monitoring is essential for early detection of complications.
Purpose:
To characterize the epidemiology of eyelid lacerations, identify risk factors for canalicular involvement, and describe postoperative complications following laceration repair.
Methods:
All patients undergoing eyelid laceration repair at a tertiary care, level I trauma center children's hospital from November 2010 to April 2021 were identified by a Current Procedural Terminology code search. Patient characteristics, surgical characteristics, and surgical outcomes were collected via chart review. Univariate analysis and multivariate logistic regression were performed to identify risk factors for canalicular involvement and postoperative complication.
Results:
A total of 165 patients were identified, of whom 136 had at least 1 week of follow-up and were further assessed for postoperative complications. The most common mechanisms of injury were dog bites (62, 38%), falls (33, 20%), and being struck by an object (22, 13%). Eyelid margin involvement was present in 108 patients (65%) and canalicular involvement in 77 patients (47%). Risk factors for canalicular involvement were hook-related injury, eyelid margin involvement, and lower eyelid injury. Thirty-three patients (24%) had postoperative complications, most commonly ptosis (7, 5%), premature stent loss (7, 5%), and eyelid margin notching (6, 4%). There was no association between postoperative complication and antibiotic use, delayed repair, or wound class.
Conclusions:
Hook-related injury, eyelid margin involvement, and lower eyelid injury are risk factors for canalicular involvement. Postoperative complications of eyelid lacerations are generally minor and are not associated with perioperative factors. Close postoperative follow-up is needed to monitor for complication development. [.
