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Canalicular lacerations: Causes, related ocular injury and management at St John Eye Hospital

Background: Canalicular lacerations cause significant morbidity if unrepaired and may be associated with serious ocular injuries. Few studies describe the causes of these injuries, and none of these were conducted in Southern Africa. Aim: The aim of this study was to describe the incidence of canalicular lacerations in terms of their causes, associated ocular injuries and management at St John Eye Hospital. Setting: St John Eye Hospital, Soweto, Gauteng Province, South Africa. Methods: This was a prospective descriptive study of all patients presenting with canalicular lacerations at St John Eye Hospital over a 7-month period. Data were collected from the patient files and analysed using descriptive statistics. Results: Seventy-eight patients presented at St John Eye Hospital with lid lacerations. Of these 78 patients, 26 (33.3%) had canalicular involvement. There was only mild male preponderance. The median age was 34 years. The most common cause of injury was assault (58%) usually involving a knife. There were associated ocular injuries in 35% of the patients. Globe rupture was relatively common (8%). All patients received lid repair under general anaesthetic. Additional surgical procedures were performed in 19%. The median duration of surgery was 103 minutes. Canalicular repair consumed 100 min of operating time per week. Conclusion: This study demonstrates that canalicular lacerations are relatively common at St John Eye Hospital. These are disproportionately caused by assault and more often associated with serious ocular injuries. This places considerable burden on already limited theatre resources and may be of particular relevance in the South African setting.