Bowman probe-guided lacrimal canalicular repair using a 24-G intravenous cannula: a retrospective case series

Abstract

Abstract Purpose: The primary goal in traumatic lacrimal canalicular lacerations is to restore canalicular continuity and prevent permanent epiphora. This study evaluated anatomical and functional outcomes and postoperative complications of Bowman probe-guided repair using a 24-gauge intravenous cannula in urgent cases where commercial canalicular stents were unavailable. Materials and methods: This retrospective single-center case series included patients undergoing primary canalicular repair with this technique between January 2022 and December 2025. Patients with incomplete records or follow-up shorter than 3 months were excluded. Demographics, injury characteristics, surgical details, cannula retention, follow-up, success rates, and complications were recorded. Anatomical success was defined as lacrimal patency on irrigation at final follow-up; functional success as absence of epiphora (Munk score 0). Results: Twenty-one patients (15 male; mean age 36±16 years) were included. The lower canaliculus was most frequently involved. Fifteen patients underwent repair within 24 hours; 19 underwent concurrent eyelid repair. Mean cannula retention and follow-up were 3.8±1.0 and 9.5±2.7 months, respectively. Anatomical and functional success were achieved in 18 (85.7%) and 17 (81.0%) patients, respectively. Complications included corneal abrasion in 3 (14.3%), early cannula loss in 2 (9.5%), and canalicular stenosis in 1 (4.8%). No punctal granuloma or wound infection occurred. Conclusion: Bowman probe-guided canalicular repair using a 24-gauge intravenous cannula achieved favorable early-to-intermediate anatomical and functional outcomes with manageable complications in this limited series. In urgent cases without commercial stents, it may be considered a readily available alternative. These findings should be supported by prospective studies with larger sample sizes.

Keywords

• Canalicular laceration
• lacrimal canaliculus
• intravenous cannula
• Bowman probe
• epiphora

Supporting Institution

No financial support was received from any institution or organization for this study.

Project Number

Not applicable.

Ethical Statement

This study was approved by the Pamukkale University Non-Interventional Clinical Research Ethics Committee (date: 13 January 2026; decision/file no: E-60116787-020-814355). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Thanks

The authors would like to thank all clinical staff involved in the perioperative care and follow-up of the patients included in this study.

Bowman prob kılavuzluğunda 24-G intravenöz kanül ile lakrimal kanalikül onarımı: retrospektif vaka serisi

Abstract

Öz Amaç: Travmatik lakrimal kanalikül laserasyonlarında temel hedef, kanalikül devamlılığını yeniden sağlamak ve kalıcı epifora gelişimini önlemektir. Bu çalışmada, ticari kanaliküler stentlerin mevcut olmadığı acil olgularda Bowman probu rehberliğinde 24 G intravenöz kanül ile yapılan onarımın anatomik ve fonksiyonel sonuçları ile ameliyat sonrası komplikasyonları değerlendirildi. Gereç ve yöntem: Bu retrospektif, tek merkezli olgu serisine, Ocak 2022–Aralık 2025 tarihleri arasında bu teknikle primer kanalikül onarımı uygulanan hastalar dahil edildi. Tıbbi kayıtları eksik veya takip süresi 3 aydan kısa olan hastalar dışlandı. Demografik özellikler, yaralanma özellikleri, cerrahi ayrıntılar, kanülün kalış süresi, takip süresi, başarı oranları ve komplikasyonlar kaydedildi. Anatomik başarı, son kontrolde irrigasyonla doğrulanan lakrimal yol açıklığı; fonksiyonel başarı ise epifora olmaması (Munk skoru 0) olarak tanımlandı. Bulgular: Çalışmaya 21 hasta (15 erkek; ortalama yaş 36±16 yıl) dahil edildi. En sık alt kanalikül yaralanması görüldü. On beş hastada ilk 24 saat içinde onarım, 19 hastada eş zamanlı göz kapağı onarımı uygulandı. Ortalama kanül kalış ve takip süreleri sırasıyla 3,8±1,0 ve 9,5±2,7 aydı. Anatomik ve fonksiyonel başarı sırasıyla 18 (%85,7) ve 17 (%81,0) hastada sağlandı. Komplikasyonlar arasında 3 hastada (%14,3) korneal abrazyon, 2 hastada (%9,5) erken kanül kaybı ve 1 hastada (%4,8) kanaliküler stenoz yer aldı. Punktal granülom veya yara enfeksiyonu görülmedi. Sonuç: Bu sınırlı olgu serisinde, Bowman probu rehberliğinde 24 G intravenöz kanül kullanılarak yapılan kanalikül onarımıyla erken ve orta dönemde olumlu anatomik ve fonksiyonel sonuçlar elde edildi; komplikasyonlar yönetilebilir nitelikteydi. Ticari stentlerin bulunmadığı acil olgularda bu yöntem, kolaylıkla temin edilebilen bir alternatif olarak düşünülebilir. Bu bulgular, daha geniş örneklemli prospektif çalışmalarla desteklenmelidir.

Keywords

• Kanalikül kesisi
• lakrimal kanalikül
• intravenöz kanül
• Bowman prob
• epifora

Supporting Institution

Bu çalışma için herhangi bir kurum veya kuruluştan finansal destek alınmamıştır.

Project Number

Not applicable.

Ethical Statement

Bu çalışma için Pamukkale Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu’ndan onay alınmıştır (tarih: 13 Ocak 2026; karar/dosya no: E-60116787-020-814355). Çalışma Helsinki Bildirgesi ilkelerine uygun olarak yürütülmüştür.

Thanks

Yazarlar, çalışmaya dahil edilen hastaların ameliyat süreci ve takiplerinde katkısı bulunan tüm klinik personele teşekkür eder.

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