Bicanalicular Annular Stent, Nasal Intubation Both Successful Lower Lid Injury Procedures

Investigators found no statistically significant differences between bicanalicular annular stent and bicanalicular nasal intubation in terms of anatomy and functional benefits. They recommend both techniques as alternatives to monocanalicular stent in the treatment of traumatic lower canalicular laceration, as detailed in a study published in Clinical Ophthalmology.

In the current retrospective, nonrandomized interventional study, researchers analyzed 85 eyes from 85 patients who were admitted for traumatic lower canalicular laceration. They found that canalicular integrity was restored by bicanalicular annular stent in 33 patients (group 1) and by bicanalicular lacrimal intubation in 25 patients (group 2).

The cohorts consisted of mostly male participants, with the cause of trauma often due to occupational hazard. The anatomical success in group 1 was 93.9% compared with that of 92% in group 2. Patency was attained in 90.9% of patients in group 1 and 80% in group 2.

Different surgical techniques using various materials have been employed to reconstruct lacrimal canalicular lacerations. Silicone is most often used to preclude obstructions, as it is soft, inert, and pliable. It prevents trauma in the healing tissue and can remain intact for long periods of time, the researchers explain. For canalicular stenting, 3 options are available: a monocanalicular stenting, an annular stent-assisted by pigtail probe, or bicanalicular intubation.

The prevention of epiphora is possible with proper diagnosis and surgery. Controversy exists regarding the use of bicanalicular versus monocanalicular stents. Experts suggest that bicanalicular stents can injure the unaffected canaliculus, as well as lead to punctal cheese wiring, chronic nasal irritation, and the formation of granuloma. A potential advantage of the bicanalicular stent is its ability to establish distal tension while surrounding tissue is repaired, which bridges distal and proximal canalicular breakages.

The investigators cite the retrospective nature of the current study as a limitation of the current study.

Reference

Mansour HO, Ramadan Ezzeldin E. Bicanalicular annular stent compared with bicanalicular nasal intubation in management of traumatic lower canalicular laceration. Clin Ophthalmol. Published online January 28, 2022. doi:10.2147/opth.s347057