This article is more than 5 years old. Information may no longer be current.
Direct canalicular repair outperforms pericanalicular repair in treating lacerations
Ophthal Plast Reconstr Surg. 2011;27(6):422-425.
Click Here to Manage Email Alerts
Direct canalicular wall sutures proved significantly more effective than pericanalicular sutures in repairing traumatic canalicular lacerations, a study found.
"[Direct sutures] could provide more secure end-to-end anastomosis, especially when the lacerated portion is deep in an avulsion injury," the study authors said. "In contrast to the previous reports, we prefer thick sutures to repair the laceration, instead of fine sutures, because of the ease of application, less cheese-wiring, and the additional effect on stenting diameter."
The retrospective study included 63 patients who underwent primary repairs of traumatic canalicular lacerations; 41 patients underwent direct canalicular wall suturing and 22 patients underwent pericanalicular suturing. Average patient age was 40 years.
Silicone stents were left in place an average of 6.2 months in the pericanalicular suture group and 4.6 months in the direct canalicular suture group; the between-group difference was statistically significant (P = .002).
Average follow-up was 7.3 months in the pericanalicular suture group and 6.4 months in the direct canalicular suture group.
Study results showed six failed procedures in the pericanalicular suture group and one failed procedure in the direct canalicular suture group; the difference was statistically significant (P = .024).
"Because the sutures passed through not only the canalicular walls but also the submucosa, and sometimes the medial canthal ligament in the [direct canalicular suturing] group, end-to-end approximation was more secure than in the [pericanalicular suturing] group, in which the sutures only engaged the submucosal tissue and might erode on tying the knots," the authors said.