Suture of old lacrimal canaliculus

The lacrimal canal rupture caused by trauma of the internal malleolus can be repaired by sutureless suture. However, fresh fractures and old fracture repair suture methods are different. General surgery is recommended after the initial diagnosis of the disease, special surgery should be prescribed. Treatment of diseases: ocular trauma Indication Old trauma of the internal iliac crest was accompanied by obstruction of the lacrimal canal or re-obstruction after suture of the lacrimal duct. Contraindications Inflammatory wounds, long-term use, and still taking aspirin before surgery Preoperative preparation 2% lidocaine 2 ~ 3ml puncture part of the table. Prepare an epidural catheter, punctum dilator, probe Surgical procedure 1. First explore the distance from the punctum at the obstruction of the lacrimal canal. 2. Insert a lacrimal probe into the punctum to reach the obstruction of the lacrimal canal. The rim was cut vertically at the temporal side of the obstruction of the canaliculus to expose the probe tip. 3. After the scar is removed, the metal core of the epidural catheter is sent to the lacrimal passage irrigation needle, and the epidural catheter is inserted into the nasal side of the lacrimal canal under the guidance of the irrigation needle. After the epidural catheter enters the lacrimal sac, the metal core is removed and sent to the nasolacrimal duct with the help of a vascular clamp. 4, completely remove the skin scars, and exchange the flaps to avoid vertical scars. A "z" shaped flap was made from the original wound as a baseline, and then the flap was sutured. complication The main complication is re-occlusion of the lacrimal duct, but the hope of successful reoperation is smaller and can be converted to other lacrimal reconstruction operations.