Efficiency and therapeutic effect of modified pigtail probe in anastomosing lacerated lacrimal canaliculus.

ABSTRACT

OBJECTIVE: To investigate the necessity of modification to the traditional pigtail probe and evaluate its efficiency and therapeutic effect in searching the nasal cut ends and anastomosing the lacerated lacrimal canaliculus. METHODS: Eighty-seven patients (including 87 eyes) suffering from canalicular laceration were randomized into two groups 41 patients treated with traditional pigtail probes (Group A) and 46 with modified pigtail probes (Group B). During the reconstruction of the lacerated canaliculi, the traditional pigtail probe and the modified pigtail probe were used respectively to seek for the nasal cut ends of lacerated lacrimal canaliculi. Peripherally inserted central catheter (PICCTM) silicone tube with diameter of 0.95 mm was intubated as a stent for 4-6 months. The surgical outcomes were retrospectively analyzed after stent removal. RESULTS: In Group B, the primary success rate of searching the nasal cut ends of lacerated lacrimal canaliculi was 93.48% (43/46) and the final success rate was 97.83% (45/46). No false passage formed in Group B. Statistical significance was found between Group A and Group B as the primary success rates of searching the nasal cut ends (X(2) equal to 10.522, P less than 0.01) and the false passage forming rates were concerned (X(2)) equal to 4.704, P less than 0.05), whereas no significance was found between the two groups as the final success rates were concerned (X(2) equal to 0.007, P larger than 0.05). The mean time of searching the nasal cut ends of lacerated lacrimal canaliculi in Group B was (5.02+/-0.73) minutes and the mean time of operation was (33.90+/-4.84) minutes, and both were significantly shorter than those of Group A (t(1) equal to 9.779, t(2) equal to 10.700, P less than 0.01). The cure rate of Group B was 95.65%, though higher than that of Group A, no statistical significance was found (Z equal to -0.007, P larger than 0.05). Totally, 2 patients (2.30%) were found to be absent of common canaliculus and underwent bicanalicular nasal intubation in the two groups. CONCLUSIONS: Pigtail probes are efficient and convenient apparatus for searching the nasal cut ends of the lacerated lacrimal canaliculi in the reconstruction of canalicular laceration. Necessary or proper modifications to the pigtail probes can minimize the risk of iatrogenic damages or complications and enhance the efficiency and therapeutic effect of canalicular repair.