The etiology and prognosis of canalicular laceration repair using canalicular anastomosis combined with bicanalicular stent intubation

Abstract Background: To evaluate the etiology of lacrimal canalicular laceration and explore possible risk factors influencing prognosis.Methods: A total of 142 patients (142 eyes) with lacrimal canalicular lacerations were reviewed and surgically repaired using canalicular anastomosis combined with bicanalicular stent intubation between March 2017 and March 2018. The analyzed data contained demographic information, types of trauma, injury location, associated additional ocular injuries and surgerical outcomes at follow-up. The main outcome measures were anatomic success rate, functional success rate, and complications of surgery.Results: The mean patient age was 42.07 years(ranging from 1-75 years) and 112 (78.87%) were men. Upper and lower canalicular lacerations were found in 14 (9.86%) and 112 (78.87%)patients, respectively, and both canalicular lacerations were found in 16 patients (11.27%). Electric bike accidents were the leading cause of injury with 76(53.52%)patients. There were 100 (70.42%)patients who had lid lacerations without tarsal plate fracture and 42 (29.58%)patients who had lid lacerations with tarsal plate fracture. Anatomic success rate was 98.59%, and functional success rate was 83.8%. Functional reconstruction failure rates were higher in patients with indirect injuries, lid lacerations with tarsal plate fracture, and with punctum splitting(P<0.05). Surgical complications were detected in the form of lacrimal punctum ectropion in 3(2.11%)patients, punctum splitting in 2(1.41%)patients, stent extrusion and loss in 2(1.41%)patients. Conclusions: Electric bike accidents have become the leading cause of injury instead of the motor vehicle accidents because of changes in lifestyle. The indirect injuries, lid lacerations with tarsal plate fracture and with punctum splitting, were significantly more likely to lead to a poor prognosis, as comfirmed by the lower functional success rate of surgery.

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Etiology and prognosis of canalicular laceration repair using canalicular anastomosis combined with bicanalicular stent intubation

10.21203/rs.2.16777/v5 ◽

2020 ◽

Author(s):

Tao Guo ◽

Xiuhong Qin ◽

Hongwei Wang ◽

Yang Lu ◽

Li Xu ◽

...

Keyword(s):

Success Rate ◽

Motor Vehicle ◽

Vehicle Accidents ◽

Tarsal Plate ◽

Plate Fracture ◽

Complications Of Surgery ◽

Trauma Injury ◽

Electric Bike ◽

Anatomic Success

Abstract Background: To evaluate the etiology of lacrimal canalicular laceration and explore the possible risk factors influencing prognosis. Methods: The data of 142 patients (142 eyes) with lacrimal canalicular lacerations who were surgically treated using canalicular anastomosis combined with bicanalicular stent intubation between March 2017 and March 2018 were reviewed. The analyzed data contained demographic information, types of trauma, injury locations, associated additional ocular injuries, and surgical outcomes at follow-up. The main outcome measures were anatomic success rate, functional success rate, and complications of surgery.Results: The mean patient age was 42.07 years (ranging from 1–75 years). Among the 142 patients, 112 (78.87%) were males. Upper and lower canalicular lacerations were found in 14 (9.86%) and 112 (78.87%) patients, respectively. Meanwhile, both upper and lower canalicular lacerations were found in 16 (11.27%) patients. Electric bike accidents comprised the leading cause of injury, accounting for 76 (53.52%) cases. There were 100 (70.42%) patients who had lid lacerations without tarsal plate fracture and 42 (29.58%) patients who had lid lacerations with tarsal plate fractures. The anatomic success rate was 98.59% and the functional success rate was 83.8%. The functional reconstruction failure rates were higher in patients with indirect injuries, lid lacerations with tarsal plate fractures, and those with punctum splitting (P<0.05). Surgical complications were detected in the form of lacrimal punctum ectropion in 3 (2.11%) patients, punctum splitting in 2 (1.41%) patients, and stent extrusion and loss in 2 (1.41%) patients. Conclusions: Electric bike accidents have become the leading cause of injury instead of motor vehicle accidents because of the changes in the lifestyles of people. Indirect injuries, lid lacerations with tarsal plate fractures, and those with punctum splitting were significantly more likely to lead to poor prognosis, as confirmed by the lower functional success rate of surgery.

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The etiology and prognosis of canalicular laceration repair using canalicular anastomosis combined with bicanalicular stent intubation

10.21203/rs.2.16777/v2 ◽

2020 ◽

Author(s):

Hongwei Wang ◽

Xiuhong Qin ◽

Jiali Ji ◽

Yang Lu ◽

Li Xu ◽

...

Keyword(s):

Success Rate ◽

Motor Vehicle ◽

Vehicle Accidents ◽

Tarsal Plate ◽

Plate Fracture ◽

Complications Of Surgery ◽

Trauma Injury ◽

Electric Bike ◽

Anatomic Success

Abstract Background: To evaluate the etiology of lacrimal canalicular laceration and explore possible risk factors influencing prognosis. Methods: A total of 142 patients (142 eyes) with lacrimal canalicular lacerations were reviewed and surgically repaired using canalicular anastomosis combined with bicanalicular stent intubation between March 2017 and March 2018. The analyzed data contained demographic information, the types of trauma, injury locations, associated additional ocular injuries and surgerical outcomes at follow-up. The main outcome measures were anatomic success, functional success, and the complications of surgery. Results: The mean patient age was 42.07years(ranging from 1-75 years) and 112 (78.87%) were men. Upper and lower canalicular lacerations were found in 14 (9.86%) and 112 patients (78.87%), respectively, and both canalicular lacerations were found in 16 patients (11.27%). Electric bike accidents were the leading cause of injury with 76 patients (53.52%). There were 100 (70.42%) patients who had lid laceration without tarsal plate fracture and 42 (29.58%) patients who had lid laceration with tarsal plate fracture. Anatomic success rate was 98.59%, and functional success rate was 83.8%. Functional reconstruction failure rates were higher in patients with indirect injuries, lid laceration with tarsal plate fracture, and with punctum splitting( P <0.05). Surgical Complications were detected in the form of lacrimal punctum ectropion in 3 (2.11%) patients, punctum splitting in 2 (1.41%) patients, stent extrusion and loss in 2 (1.41%) patients. Conclusions: Electric bike accidents have become the leading cause of injury instead of the motor vehicle accidents because of changes in lifestyle. The indirect injuries, lid laceration with tarsal plate fracture and with punctum splitting, were significantly more likely to lead to a poor prognosis, as comfirmed by the lower functional success rate of surgery.

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The etiology and prognosis of canalicular laceration repair using canalicular anastomosis combined with bicanalicular stent intubation

10.21203/rs.2.16777/v3 ◽

2020 ◽

Author(s):

Hongwei Wang ◽

Xiuhong Qin ◽

Jiali Ji ◽

Yang Lu ◽

Li Xu ◽

...

Keyword(s):

Success Rate ◽

Motor Vehicle ◽

Vehicle Accidents ◽

Tarsal Plate ◽

Plate Fracture ◽

Complications Of Surgery ◽

Trauma Injury ◽

Electric Bike ◽

Anatomic Success

Abstract Background: To evaluate the etiology of lacrimal canalicular laceration and explore possible risk factors influencing prognosis. Methods: A total of 142 patients (142 eyes) with lacrimal canalicular laceration were reviewed and surgically repaired using canalicular anastomosis combined with bicanalicular stent intubation between March 2017 and March 2018. The analyzed data contained demographic information, types of trauma, injury location, associated additional ocular injuries and surgerical outcomes at follow-up. The main outcome measures were anatomic success rate, functional success rate, and the complications of surgery.Results: The mean patient age was 42.07 years(ranging from 1-75 years) and 112 (78.87%) were men. Upper and lower canalicular lacerations were found in 14 (9.86%) and 112 patients (78.87%), respectively, and both canalicular lacerations were found in 16 patients (11.27%). Electric bike accidents were the leading cause of injury with 76 patients (53.52%). There were 100 (70.42%) patients who had lid laceration without tarsal plate fracture and 42 (29.58%) patients who had lid laceration with tarsal plate fracture. Anatomic success rate was 98.59%, and functional success rate was 83.8%. Functional reconstruction failure rates were higher in patients with indirect injuries, lid laceration with tarsal plate fracture, and with punctum splitting(P<0.05). Surgical Complications were detected in the form of lacrimal punctum ectropion in 3 (2.11%) patients, punctum splitting in 2 (1.41%) patients, stent extrusion and loss in 2 (1.41%) patients. Conclusions: Electric bike accidents have become the leading cause of injury instead of the motor vehicle accidents because of changes in lifestyle. The indirect injuries, lid laceration with tarsal plate fracture and with punctum splitting, were significantly more likely to lead to a poor prognosis, as comfirmed by the lower functional success rate of surgery.

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The etiology and prognosis of canalicular lacerations repair using canalicular anastomosis combined with bicanalicular stent intubation

10.21203/rs.2.16777/v1 ◽

2019 ◽

Author(s):

Tao Guo ◽

Xiuhong Qin ◽

Jiali Ji ◽

Yang Lu ◽

Li Xu ◽

...

Keyword(s):

Motor Vehicle ◽

Vehicle Accidents ◽

Tarsal Plate ◽

Plate Fracture ◽

Silicone Intubation ◽

Silicone Tube Intubation ◽

Trauma Injury ◽

Complication Of Surgery ◽

Anatomic Success

Abstract Purpose: To evaluate the etiology of lacrimal canalicular lacerations and explore possible risk factors influencing prognosis. Methods: A total of 142 patients (142 eyes) with lacrimal canalicular lacerations were reviewed and surgically repaired between March 2017 and March 2018. The analyzed data contained demographic information, the type of trauma, injury locations, associated additional ocular injuries and surgerical outcomes at follow-up. The main outcome measures were anatomic success, functional success, and the complication of surgery. Results: The mean patient age was 42.07years(ranging from 1-75 years) and 112 (78.87%) were men. Upper and lower canalicular lacerations were found in 14 (9.86%) and 112 patients (78.87%), respectively. Electromobile accidents were the leading cause of injury with 76 patients (53.52%). There were 100 (70.42%) patients who had lid laceration without tarsal plate fracture and 42 (29.58%) patients who had lid laceration with tarsal plate fracture. Functional reconstruction failure rates were higher in patients with indirect injuries, lid laceration with tarsal plate fracture, and with laceration punctum crack( P <0.05). Surgical Complications were detected in the form of lacrimal punctum ectropion in 3 (2.11%) patients, lacrimal punctum crack in 2 (1.41%) patients, stent extrusion and loss in 2 (1.41%) patients. Conclusions: Electromobile accidents have become the leading cause of injury instead of the motor vehicle accidents because of changes in lifestyle. Silicone intubation was most commonly used in surgery with high anatomic success. The indirect injuries, lid laceration with tarsal plate fracture and with lacrimal punctum crack, were significantly more likely to lead to a poor prognosis, as comfirmed by the lower functional success rate of surgery. Keywords: Canalicular lacerations; etiology; prognosis; epiphora; silicone tube intubation

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How effective is cyanoacrylate closure in small saphenous vein insufficiency? A single center experience

Vascular ◽

10.1177/17085381211051494 ◽

2021 ◽

pp. 170853812110514

Author(s):

Görkem Yiğit

Keyword(s):

Success Rate ◽

Saphenous Vein ◽

Treatment Method ◽

Technical Failure ◽

Single Center ◽

Single Center Experience ◽

Kaplan Meier ◽

The Mean ◽

Anatomic Success

Objectives The present study was aimed to evaluate the efficacy and early outcomes of n-butyl cyanoacrylate (NBCA) ablation in small saphenous vein (SSV) insufficiency. Methods In this single-center, retrospective, single-arm study, NBCA ablation was performed in 80 patients with SSV insufficiency between September 2018 and May 2020. Primary outcomes (anatomic success rate and occlusion rate) and secondary outcomes (VCSS and AVVQ scores) of the patients were analyzed. Results No technical failure and device-related complications were encountered. Anatomic success rate was 100% after procedures. Each treated SSV was occluded on colored Doppler ultrasonography immediately after the procedure, and all veins remained occluded at 2 weeks after the procedure. Partial recanalization was observed in five patients at 12-month follow-up. Kaplan–Meier analysis revealed an occlusion rates at 6 months and 12 months follow-up were 97.5% and 93.75%, respectively. The mean pretreatment VCSS (4.72 ± 2.04) decreased to 1.61 ± 0.93, 0.87 ± 0.58, and 0.73 ± 0.52 at 2 weeks, 6 months, and 12 months after treatment, respectively ( p < .001). The mean pretreatment AVVQ score (11.92 ± 2.23) decreased to 8.2 ± 1.89, 4.2 ± 1.16, and 3.32 ± 1.19 at 2 weeks, 6 months, and 12 months after treatment, respectively ( p < .001). The Clinical, Etiologic, Anatomic, and Pathophysiology clinical classification at 12 months demonstrated a significant reduction in disease severity compared with preoperative values ( p < .001). There was no mortality and major adverse events including anaphylaxis and pulmonary thromboembolism (PTE) related to procedure after follow-ups. Moreover, there were no symptoms or signs of any sural nerve injury and no cases of skin necrosis, infection, or hyperpigmentation. In addition, no hematoma, deep venous thrombosis, and hypersensitivity reactions were observed. Phlebitis-like abnormal reaction was observed in three patients (3.8%). Conclusions In conclusion, in patients with SSV insufficiency, NBCA ablation with VenaBlock® system appears to be an effective and reliable treatment method. At the 12-month follow-up, the NBCA of SSVs showed a low recanalization rate and had a satisfactory improvement on the VCSS and AVVQ scores.

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Injury Characteristics and the Clinical Outcome of Subtalar Dislocations: A Clinical and Radiographic Analysis of 25 Cases

Foot & Ankle International ◽

10.1177/107110070302400210 ◽

2003 ◽

Vol 24 (2) ◽

pp. 158-163 ◽

Cited By ~ 75

Author(s):

Christopher Bibbo ◽

Robert B. Anderson ◽

W. Hodges Davis

Keyword(s):

Subtalar Joint ◽

Motor Vehicle ◽

High Energy ◽

Aofas Score ◽

Exact Test ◽

Subtalar Dislocation ◽

Vehicle Accidents ◽

The Mean ◽

Radiographic Changes

The objective of this study was to determine the mechanisms of injury and pattern of associated foot and ankle injuries and systemic injuries associated with subtalar dislocations, and, correlate these data with the radiographic and clinical/functional outcome of patients after subtalar dislocation. Results: Twenty-five patients with a subtalar dislocation were identified over a seven year period. The mean patient age was 38 years. Males (n=19) comprised 76% of patients, with a mean age of 36 years. High energy mechanisms (motor vehicle accidents, falls) accounted for 68% of subtalar dislocations. Although high energy mechanisms showed a strong trend toward open subtalar dislocations, the association was not statistically significant (p=0.0573, Fisher's exact test). Closed dislocations predominated (75%). Left and right-sided dislocations were nearly equally distributed, even among motor vehicle accidents. Medial dislocations predominated (65%): these were not influenced by mechanism of injury and did not result in statistically lower AOFAS ankle/hindfoot scores. Subtalar dislocation was irreducible (requiring open reduction) in 32%, with higher energy mechanisms of injury being statistically associated with an irreducible subtalar dislocation (p=0.0261, Fisher's exact test). Block to reduction was evenly distributed among soft tissue elements (posterior tibial tendon, flexor hallucis longus tendon, capsule, extensor retinaculum) and osseous elements. Eighty-eight percent of patients incurred concomitant injuries to the foot and ankle (95% of which were closed injuries), namely, the ankle and talus. Systemic injuries occurred in 88% of patients. At a mean follow-up of five years, the mean AOFAS score of the subtalar dislocation side was significantly lower (mean=71 vs. 93, p=0.0007, unpaired Student's t-test). No statistical relation was found between the number of associated extremity injuries and AOFAS score (Spearman correlation coefficient, r=(–)0.236, p=0.331). Radiographic follow-up demonstrated 89% of ankles with radiographic changes (31% symptomatic); however, the majority of these patients (61%) had an associated ankle injury. The subtalar joint demonstrated radiographic changes in 89% of patients, with 63% being symptomatic; 75% of patients with subtalar joint changes incurred a fracture about the subtalar joint at the time of dislocation. Four patients went on to subtalar fusion at an average of 8.8 months post-dislocation. The midfoot showed radiographic changes in 72% of patients, with only 15% of these patients being symptomatic. All patients with midfoot symptoms were well controlled by nonsurgical measures.

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RESULTS OF INTRALESIONAL TRIAMCINOLONE ACETONIDE FOR CHALAZION TREATMENT

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2011.5.13 ◽

2011 ◽

pp. 100-104

Author(s):

Thi Thu Nguyen ◽

Viet Hien Vo ◽

Thi Em Do

Keyword(s):

Success Rate ◽

Key Words ◽

Triamcinolone Acetonide ◽

Lower Eyelid ◽

Upper Eyelid ◽

Interventional Trial ◽

The Mean ◽

First Time

The study use intralesional triamcinolone acetonide injection proceduce for chalazion treatment.1. Objectives: To evaluate results of intralesional triamcinolone acetonide injection for chalazion treatment. 2. Method: This noncomparative prospective interventional trial included 72 chalazions of 61 patients. 3. Results: 61 patients (72 chalazions) with 19 males (31.1%) và 42 females (68.9%), the mean age was 24 ± 9,78 years. 31.1% patients was the first time chalazion and 68.9% patients was more than one times chalazion including 78.6% patients was recurrent at the first position and 21.4% patients occur at new position. 72 chalazions with 16 (22.2%) chalazions was treated before and 56 (77.8%) chalazions wasn’t done that. 72 chalazions with 49 chalazions (68.1%) are local in upper eyelid and 23 chalazions (31.9%) are local in lower eyelid. The mean of chalazion diameter is 6.99 ± 3.03mm. Intralesional triamcinolone acetonide is injected to treat 72 chalazions with 16 (22.2%) chalazions are injected through the route of skin and 56 (77.8%) chalazions are injected through the route of conjunctiva. After 2 weeks follow-up, the success rate was 93.1% and 6.9% failed. 4. Conclusion: intralesional triamcinolone acetonide injection for chalazion treatment is really effective. Key words: chalazion, intralesional triamcinolone acetonide.

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Surgical correction of severe congenital ptosis using a modified frontalis muscle advancement technique: A single-arm trial

European Journal of Ophthalmology ◽

10.1177/1120672121995754 ◽

2021 ◽

pp. 112067212199575

Author(s):

Lei Zhang ◽

Mingyu Ren ◽

Yuqing Yan ◽

Wenjuan Zhai ◽

Lihong Yang ◽

...

Keyword(s):

Success Rate ◽

Advancement Flap ◽

Orbicularis Muscle ◽

Congenital Ptosis ◽

Inferior Margin ◽

Field Of Vision ◽

Vertical Incision ◽

Registration Number ◽

The Mean

Purpose: To describe our experience with a modified frontal muscle advancement flap to treat patients with severe congenital ptosis. Methods: Analysis of the clinical charts of 154 patients who underwent a modified frontal muscle advancement flap. The FM was exposed by a crease incision. The FM flap was created by deep dissection between the orbicularis muscle and orbital septum from the skin crease incision to the supraorbital margin and subcutaneous dissection from the inferior margin of the eyebrow to 0.5 cm above the eyebrow. No vertical incision was made on the FM flap to ensure an intact flap wide enough to cover the entire upper tarsal plate. Contour, symmetry of height, marginal reflex distance (MRD1), and complications were assessed. Mean follow-up was 10 months. Results: The mean patient age was 7.6 ± 5.6 (range, 2–18) years. The mean MRD1 was 3.2 ± 1.3 mm after the operation. All bilateral cases achieved symmetry and optimal lid contour; 17 unilateral cases were under corrected, with a success rate of 89.0%. Complications such as entropion, exposure keratitis, FM paralysis, frontal hypoesthesia, severe haematoma, and entropion were not observed in our series. Conclusion: A modified frontal muscle advancement flap produced a high success rate with a clear field of vision, mild trauma, and few complications. This technique is relatively simple and should be considered for correcting severe congenital ptosis. Date of registration: 29-03-2020 Trial registration number: ChiCTR2000031364 Registration site: http://www.chictr.org/

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Unilateral lateral rectus recession is an effective surgery for intermittent exotropia in young children

BMC Ophthalmology ◽

10.1186/s12886-020-01778-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Oriel Spierer ◽

Abraham Spierer

Keyword(s):

Young Children ◽

Success Rate ◽

Lateral Rectus ◽

Intermittent Exotropia ◽

Age At Surgery ◽

Surgical Methods ◽

Before And After ◽

The Mean ◽

Consecutive Esotropia

Abstract Background Different surgical methods have been suggested for the correction of intermittent exotropia. Unilateral lateral rectus recession has been described as a surgical alternative for small and moderate-angle exotropia. In general, previous studies did not focus on the outcomes of unilateral lateral rectus recession in young children with intermittent exotropia. The purpose of this study is to evaluate the surgical outcomes of unilateral lateral rectus recession in the treatment of moderate-angle exotropia (≤ 25 PD (prism diopters)) in children. Methods The charts of all patients younger than 12 years of age with moderate-angle exotropia (up to 25 PD) who were operated during the years 2006–2018 were retrospectively reviewed. Fifty-eight patients underwent unilateral lateral rectus recession and had a minimum follow up of 6 months. The angle of exotropia (PD) before and after surgery and the success rate were documented. Results Mean age at surgery was 6.4 ± 1.9 (range 3.5–11.0) years. Exotropia improved from a preoperative angle of 21.4 ± 4.0 PD to 3.5 ± 5.9 PD postoperatively (p < 0.001). Success rate, defined as deviation of ≤ 10 PD, was achieved in 86.2%. There were 2 (3.4%) cases of overcorrection (consecutive esotropia). There were no intra- or postoperative complications. The mean follow-up duration after surgery was 2.3 ± 1.7 years. Conclusions In children with moderate angle exotropia, good postoperative success rate was achieved by performing unilateral lateral rectus recession.

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TEVAR versus open repair of blunt traumatic descending aortic injury in polytraumatic patients involved in motor vehicle accidents

The Cardiothoracic Surgeon ◽

10.1186/s43057-021-00040-9 ◽

2021 ◽

Vol 29 (1) ◽

Author(s):

Imthiaz Manoly ◽

Mohamed El Tahan ◽

Maymoona Al Shuaibi ◽

Fatimah Adel ◽

Mohammed Al Harbi ◽

...

Keyword(s):

Blood Transfusion ◽

Hospital Stay ◽

Open Repair ◽

Motor Vehicle ◽

Aortic Injury ◽

Motor Vehicle Accidents ◽

Time Interval ◽

Vehicle Accidents ◽

Severity Scores ◽

The Mean

Abstract Background Thoracic endovascular aortic repair (TEVAR) is the standard-of-care for treating traumatic aortic injury (TAI). Few retrospective studies compared TEVAR to open repair in blunt traumatic aortic injury (BTAI). Our objectives were to compare the early outcomes of TEVAR for blunt traumatic descending aortic injury to open repair (OR) in polytraumatic patients involved in motor vehicle accidents (MVA). Results Between February 2005 and April 2017, 71 patients with TAI due to MVA presented to our institution. All patients with descending aortic injuries were considered for open repair (n = 41) or TEVAR (n = 30) if there was no contraindication. The primary outcome was mortality, and secondary outcomes were stroke, paraplegia, intensive care unit (ICU), and hospital stay. The mean age was 28.4 ± 10.1 years in the OR group and 33.3 ± 16.6 years in TEVAR-group (P = 0.13). The injury severity scores were 41 ± 10 in the OR group and 33 ± 17 in the TEVAR group (P = 0.03). Patients in the OR group underwent emergency repair with a mean time of 0.56 ± 0.18 days from arrival. The TEVAR group had a longer time interval between arrival and procedure (2.1 ± 1.7 days, P = 0.001). The OR group had more blood transfusion (24 (58.5%) vs. 8 (27.5%), P = 0.002), renal impairment (6 (14.6%) vs. 1 (5.50%), P = 0.23), and wound infection (21 (51.2%) vs. 3 (10%), P < 0.001). Three TEVAR patients had a perioperative stroke compared to two patients in the OR group (P = 0.64). There was no difference in the mean ICU (6 ± 8.9 vs. 5.3 ± 2.9 days; P = 0.1) or hospital stay (20.1 ± 12.3 vs. 20.1 ± 18.3, P = 0.62) between the two groups. There were four deaths in the OR group and none in the TEVAR group (P = 0.13). Conclusion The results of TEVAR were comparable with the open repair for traumatic aortic injury with good early postoperative outcomes. TEVAR repair could be associated with lower mortality, blood transfusion, and infective complications. However, the complexity of the injury and technical challenges were higher in the open group.

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