Canalicular Lacerations

Overview

• Canalicular lacerations are breaks (interruptions) in {the} normal tear duct drainage system. If not repaired promptly, tearing will usually result.
• This systems originates with {the} puncta (there is one in both {the} upper and {the} lower eyelid) and is a conduit for tears to travel from {the} eyelid through {the} nasolacrimal sac into {the} nose.
• Tension, from trauma such as a blow from {the} fist, can result in an eyelid laceration which involves {the} canalicular system.
• Repair requires re-approximation of {the} eyelid as well as re-approximation of {the} conduit; this is best achieved with a stent such as with silastic and fine sutures such as 6,7, or 8-0 vicryls.

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1. Lacrimal Gland
2. Tear Film on {the} eye
3. Canalicular and Nasolacraiml duct

The photos below show a patient who was hit in their right eye with a fist and who sustained a canalicular laceration:

Treatment

There are several different means to repair such an injury. Placement of a stent (silastic tubing) helps maintain proper alignment of {the} conduit and prevent stricture after {the} repair.

• Bi-canalicular stent
  This places places a silicone stent in both {the} traumatized (lacerated) canalicular system as well as {the} normal. One disadvantage of this technique is {the} potential damage to {the} "good" canalicular system.

• Mono-canalicular stent
  This places places a silicone stent ONLY in {the} traumatized (lacerated) canalicular system and thus avoids potential damage to {the} "good" canalicular system. A mini-Monoka or Monoka monocanalicular stent is typically used

  These three photos show a canalicular laceration and its repair with a Monoka monocanalicular stent.