Topic: ESOPRS 2021 ePoster sessions
Time: Sep 17, 2021 16:00 Amsterdam, Berlin, Rome, Stockholm, Vienna, 15:00 London
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Outcomes of Canalicular Tear Repair with Intravenous Cannula: Descriptive Study of an Economic Approach
Author: Paridhi Todi
ePoster Number: 293
Canalicular laceration in eyelid trauma is commonest injury of lacrimal system. Repair done within 48h reduces risk of scarring and epiphora. While silicon stent is most popular, they are costly and subject to availability. Present study aims to demonstrate and evaluate a modified and economical way of repairing canalicular tear using a 24-gauge intravenous cannula in a resource limited tertiary care centre.
10 patients with lower canalicular tear presenting to ER were taken in the study after informed consent. After identification of the distal cut end, 24-gauge IV cannula was inserted inside the catheter and guided through the nasal end without the needle. The cannula was flushed with sterile water to ensure positioning. Excess tube was cut short to 1.5cm and sutured to the skin below the lid margin. Additional eyelid injuries were repaired after the lacrimal intubation. The cannula was left in situ for 6 weeks. The functional and anatomical success of the procedure was evaluated during a 3 month follow-up. Data was analysed using descriptive statistics.
Of the 10 patients, functional success was seen in 6 patients. Epiphora was present in 4 patients postoperatively with premature extrusion of cannula seen in 2 cases. Cosmetic complain, foreign-body sensation and discharge were some complications noted. Good anatomical apposition was seen in all patients.
A clear advantage was that the cost and non-availability of silicon stents is overcome by this approach, ensuring primary canalicular repair at presentation. The cannula wings provides comfortable grip during insertion and its hard but flexible material making guidance through the canaliculus straightforward. Flashback chamber of the cannula allows flushing to check the correct placement of catheter within the lacrimal system inherently convenient. However, the cut end sutured to lower lid facing outwards and away from the eye may get blocked by debris and become a nidus of infection. In conclusion, our modification of using intravenous cannula is found to be economical, handily available with good anatomical and functional outcome.
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Abstract ID: 21-201