Canalicular Laceration Repair With Three Different Intubation Techniques: A Retrospective Study

Canalicular lacerations require timely and effective surgical repair to prevent epiphora and maintain lacrimal function. While various intubation techniques exist, there is no clear consensus on the optimal method. This study compares monocanalicular, bicanalicular, and annular intubation techniques in terms of success rates and complications.

The patients who underwent canalicular repair surgery between January 1998 and August 2023 have been retrospectively reviewed. The study analyzed 3 intubation methods: monocanalicular, bicanalicular, and annular intubation. The evaluation parameters included anatomical success (patency confirmed by lacrimal lavage), functional success (absence of epiphora), complication rates, and the duration of tube retention.

This study included 165 eyes from 165 patients, with a male-to-female ratio of 79.4% and 20.6%, and a mean age of 32.6 years. The most common intubation technique used was monocanalicular intubation (46.7%), followed by annular intubation (29.1%), and the least used was bicanalicular intubation (24.2%). Canalicular damage was predominantly traumatic (90.3%). The lower canaliculus was the most frequently affected. Anatomical and functional success rates were 95.7% and 90.7%, respectively, for all cases. The most common complications were slit-like punctum and conjunctival irritation, each observed in 2.4% of cases; 93.7% of cases had no issues related to intubation. Monocanalicular intubation was associated with the fewest complications, while bicanalicular intubation tends to lead to more complications ( p = 0.047). There was a strong negative correlation between complications and anatomical success (ρ = -0.75, p < 0.01) and, surprisingly, a positive correlation with functional success (ρ = 0.560, p < 0.01). A weak negative correlation was observed between anatomical success and tube duration (ρ = 0.177, p < 0.05); however, it was not clinically significant.

This study demonstrates that bicanalicular silicone intubation was associated with the highest complication rate, whereas monocanalicular intubation had the lowest. Indicating that the choice of intubation method influences the occurrence of complications. Despite this, no significant differences were observed between the intubation types in terms of anatomical or functional success, as both anatomical success and functional success were high across all groups. A strong negative correlation between complications and anatomical success, suggesting that more complications lead to poorer anatomical outcomes.