Abstract：
Locating the medial cut end during late repair of canalicular lacerations can be challenging.
The aim of this study was to evaluate the effectiveness and long-term outcomes of a new anatomy-based method for solving the problem of locating the medial cut end.
This retrospective interventional study included 85 eyes of 85 consecutive adult patients with unilateral inferior canalicular lacerations who underwent late primary (≥2 days after injury) or secondary (≥6 months after initial treatment) surgery. Before surgery, the lacerations were classified as lateral, central, or medial according to the \'distance from the punctum to the distal end\' of the lacerated inferior canaliculus. The time spent to locate the proximal lacerated end (TSL) was recorded. All patients were followed up for ≥1 year to evaluate the lacrimal passage patency and the distance between the superior and inferior punctum (DBSIP, to assess cosmesis).
There were 16 (18.82%) lateral-type, 55 (64.71%) central-type, and 14 (16.47%) medial-type canalicular lacerations. The TSL was 3.48 ± 1.05 (range 0.9-6.8) min for all patients and differed significantly among the three types of canalicular lacerations (P < 0.001). Lacrimal irrigation showed patent lacrimal passages in 69 patients (81.18%) at 3 months and a further 4 patients (4.71%) at 6 months, residual stenosis without obstruction in 5 patients (5.88%), and obstruction in 7 patients (8.24%). The postoperative DBSIP on the affected side was shorter than the preoperative DBSIP (2.66 ± 0.66 vs. 3.09 ± 1.72 mm, P = 0.006) and comparable to that on the unaffected side (2.78 ± 0.40 mm).
Our new anatomy-based method is efficient and achieves good long-term outcomes for all types of late canalicular repair.
The aim of this study was to evaluate the effectiveness and long-term outcomes of a new anatomy-based method for solving the problem of locating the medial cut end.
This retrospective interventional study included 85 eyes of 85 consecutive adult patients with unilateral inferior canalicular lacerations who underwent late primary (≥2 days after injury) or secondary (≥6 months after initial treatment) surgery. Before surgery, the lacerations were classified as lateral, central, or medial according to the \'distance from the punctum to the distal end\' of the lacerated inferior canaliculus. The time spent to locate the proximal lacerated end (TSL) was recorded. All patients were followed up for ≥1 year to evaluate the lacrimal passage patency and the distance between the superior and inferior punctum (DBSIP, to assess cosmesis).
There were 16 (18.82%) lateral-type, 55 (64.71%) central-type, and 14 (16.47%) medial-type canalicular lacerations. The TSL was 3.48 ± 1.05 (range 0.9-6.8) min for all patients and differed significantly among the three types of canalicular lacerations (P < 0.001). Lacrimal irrigation showed patent lacrimal passages in 69 patients (81.18%) at 3 months and a further 4 patients (4.71%) at 6 months, residual stenosis without obstruction in 5 patients (5.88%), and obstruction in 7 patients (8.24%). The postoperative DBSIP on the affected side was shorter than the preoperative DBSIP (2.66 ± 0.66 vs. 3.09 ± 1.72 mm, P = 0.006) and comparable to that on the unaffected side (2.78 ± 0.40 mm).
Our new anatomy-based method is efficient and achieves good long-term outcomes for all types of late canalicular repair.
摘要：
背景：在泪小管撕裂的后期修复过程中定位内侧切割端可能具有挑战性。
目的：本研究的目的是评估一种基于解剖学的新方法的有效性和长期结果，以解决内侧切口末端的定位问题。
方法：这项回顾性介入研究包括85例连续的单侧下小管撕裂患者的85只眼，这些患者接受了晚期初次手术（损伤后≥2天）或二次手术（初始治疗后≥6个月）。手术前,撕裂被分类为外侧，中央,根据泪点到撕裂的下小管远端的距离或内侧。记录用于定位近端撕裂末端(TSL)的时间。所有患者均随访≥1年，以评估泪道通畅性及上下泪点之间的距离（DBSIP，评估宇宙)。
结果：有16（18.82%）侧型，55（64.71%）中央型，内侧型泪小管撕裂14例（16.47%）。所有患者的TSL为3.48±1.05（范围0.9-6.8）min，三种类型的泪小管撕裂之间存在显着差异（P<0.001）。泪管冲洗显示，3个月时69例患者（81.18%），6个月时4例患者（4.71%），残余狭窄无梗阻5例(5.88%),梗阻7例(8.24%)。患侧术后DBSIP比术前DBSIP短(2.66±0.66vs.3.09±1.72mm,P=0.006），与未受影响的一侧（2.78±0.40mm）相当。
结论：我们的新的基于解剖学的方法是有效的，并且对于所有类型的晚期泪小管修复都能获得良好的长期结果。
目的：本研究的目的是评估一种基于解剖学的新方法的有效性和长期结果，以解决内侧切口末端的定位问题。
方法：这项回顾性介入研究包括85例连续的单侧下小管撕裂患者的85只眼，这些患者接受了晚期初次手术（损伤后≥2天）或二次手术（初始治疗后≥6个月）。手术前,撕裂被分类为外侧，中央,根据泪点到撕裂的下小管远端的距离或内侧。记录用于定位近端撕裂末端(TSL)的时间。所有患者均随访≥1年，以评估泪道通畅性及上下泪点之间的距离（DBSIP，评估宇宙)。
结果：有16（18.82%）侧型，55（64.71%）中央型，内侧型泪小管撕裂14例（16.47%）。所有患者的TSL为3.48±1.05（范围0.9-6.8）min，三种类型的泪小管撕裂之间存在显着差异（P<0.001）。泪管冲洗显示，3个月时69例患者（81.18%），6个月时4例患者（4.71%），残余狭窄无梗阻5例(5.88%),梗阻7例(8.24%)。患侧术后DBSIP比术前DBSIP短(2.66±0.66vs.3.09±1.72mm,P=0.006），与未受影响的一侧（2.78±0.40mm）相当。
结论：我们的新的基于解剖学的方法是有效的，并且对于所有类型的晚期泪小管修复都能获得良好的长期结果。
