Pearls for Tackling canalicular injuries of Lacrimal Apparatus Presentation by dr vidushi sharma dr suresh k pandey suvi eye institute kota india (email:suvieye@gmail.com)
Ähnlich wie Pearls for Tackling canalicular injuries of Lacrimal Apparatus Presentation by dr vidushi sharma dr suresh k pandey suvi eye institute kota india
Ähnlich wie Pearls for Tackling canalicular injuries of Lacrimal Apparatus Presentation by dr vidushi sharma dr suresh k pandey suvi eye institute kota india (20)
Pearls for Tackling canalicular injuries of Lacrimal Apparatus Presentation by dr vidushi sharma dr suresh k pandey suvi eye institute kota india
1. Tackling Canalicular Injuries
Dr. Vidushi Sharma, MD, FRCS (UK)
Dr. Suresh K Pandey, MS, ASF (USA)
SuVi Eye Institute & Lasik Laser Center
Kota, RAJ., India
Web site:www.suvieye.com
E-mail:suvieye@gmail.com
Phone +91 9351412449
2. Eyelid trauma
Increasing incidence due
to RTAs and other injuries
Evaluate ABCs
Look for globe injury –
repair first
RBH, emphysema or
orbital fractures may be
present
3. Assessment
Tissue loss
Canthal ligament injury
Photographs
Also Tetanus vaccination and
appropriate treatment for bites
Medico-legal implications
4. Canalicular tear
Canalicular Injury in 16% to 36%
eyelid tears (Ophthalmolge Nov 2001 & AJO 2008))
24 canalicular repairs in 3 years at
LVPEI (AJO, Feb 2008)
63% oculoplastic surgeons in UK
treated 1-5 cases per year (CEO, 2006)
Most don’t reach the right place for
primary repair
Some repair only the lower
5. Canalicular Stents
Silicon the material of choice
Many variations and preferences
Monocanalicular/ Bicanalicular
Monocanalicular – To the sac/ to the nose
Crawford bicanalicular
Ritleng, full-length Monoka –
monocnalicular to the nose
Mini-Monoka – monocanalicular to the
sac
6. Stents
Mini Monoka – the most widely
recommended stent for single
canalicular repair
Self-retaining, no need for sutures, less
extrusion
Neoflon and silicon rods (part of silicon
sling) have been and are still commonly
used – greater chances of extrusion
Retain for 1-6 months
7. General principles
Hemostasis – xylocaine with
adrenalin even if GA, not too much
Clean the injured area – look for FBs
End to end / pericanalicular suturing
Identify the medial cut end under
microscope magnification – using
skin retractors and Q tips (also dye/
viscoelastic/ air)
8.
9.
10. Conclusions
Early repair crucial
Good illumination and
magnification
Stents markedly improve
cosmetic as well as
functional results
Even patients not patent
to syringing often
asymptomatic if well-
aligned
12. Tackling Canalicular Injuries
Dr. Vidushi Sharma, MD, FRCS (UK)
Dr. Suresh K Pandey, MS, ASF (USA)
SuVi Eye Institute & Lasik Laser Center
Kota, RAJ., India
Web site:www.suvieye.com
E-mail:suvieye@gmail.com
Phone +91 9351412449