Complex Delayed Repair of Canalicular Laceration: A Case Report
Author: Alda Shyqyriu
Base Hospital / Institution: Oculus Eye Clinic
ePoster presentation
Abstract ID: 25-211
Purpose
To describe a novel surgical technique for the delayed repair of a canalicular laceration, one year post-trauma, and assess the functional and aesthetic outcomes of the procedure.
Methods
A 74-year-old female patient, with a history of ectropion surgery 5 years ago and orbital trauma with lacrimal duct laceration one year prior, presented for canalicular reconstruction. The previous ectropion surgery had weakened the tissue, complicating the repair. The trauma resulted in a full-thickness rupture of the inferior palpebra and complete destruction of the inferior lacrimal duct. Despite undergoing initial laceration repair at a national trauma hospital, the lacrimal duct was not reconstructed. After one year, a novel technique was used: silicone tubes were inserted through the inferior punctum into the inferior canaliculus. The silicone tube was first sutured to the pigtail probe. Using the pigtail probe, the tubes were then guided into the superior canaliculus, reaching the lacrimal sac. The silicone tube was pulled through the superior canaliculus and sutured in place with a 6-0 suture. Finally, the muscle and skin of the inferior palpebra were sutured to restore both functional and aesthetic integrity.
Results
Successful implantation of the silicone tube and restoration of canalicular drainage were achieved. Two months post-operatively, the patient showed no signs of lacrimal obstruction or eyelid malposition. The aesthetic result was satisfactory with minimal scarring and improved eyelid function.
Conclusion
This case highlights the feasibility of delayed canalicular repair one year after trauma, using a pigtail probe to guide silicone tube implantation. Despite the typical recommendation for early intervention, the patient demonstrated good functional recovery and acceptable cosmetic results. Previous ectropion surgery likely contributed to the delicacy of the eyelid structures, but the novel approach successfully overcame these challenges. This technique offers an effective solution for patients with delayed canalicular lacerations, particularly in cases with fragile eyelid anatomy.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Matina | Cobo | Oculus Eye Clinic |
