Medication Summary
The medications used in treating canalicular lacerations are antibiotics that help to prevent infection. Intraoperatively, the wounds are decontaminated with copious irrigation of antibiotic solution. Postoperatively, topical antibiotic ointment is applied to the skin wound, topical antibiotic solution is instilled to treat the lacrimal system, and system antibiotics are used if wound contamination is possible. An ophthalmic antibiotic steroid often is used for topical use since it also decreases inflammation.
Antibiotics
Class Summary
Used in prevention of postoperative infection, inflammation, and scarring of the lacrimal drainage system.
Dexamethasone/tobramycin (TobraDex)
Indicated for infections of the eye. Tobramycin interferes with bacterial protein synthesis by binding to 30S and 50S ribosomal subunits, which results in a defective bacterial cell membrane. Dexamethasone decreases inflammation by suppressing migration of polymorphonuclear leukocytes and reducing capillary permeability.
Cephalexin (Keflex, Biocef, Keftab)
Indicated for infections. First-generation cephalosporin arrests bacterial growth by inhibiting bacterial cell wall synthesis. Bactericidal activity against rapidly growing organisms. Primary activity against skin flora; used for skin infections or prophylaxis in minor procedures.
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Toddler who sustained a dog bite injury with isolated canalicular laceration of the left lower lid.
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Postoperative (1.5 y after injury) appearance of toddler who sustained a dog bite injury with isolated canalicular laceration of the left lower lid. This photo demonstrates normal anatomy and function of the eyelid.
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Canalicular system intubated with 6-0 Prolene suture prior to passing a segment of Crawford stent in a patient who sustained superior canalicular laceration from a fingernail injury while playing basketball.
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Postoperative appearance of a patient who sustained superior canalicular laceration from a fingernail injury while playing basketball.
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Canalicular laceration in the setting of a more extensive medial canthal injury in a woman involved in a motor vehicle accident.
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Postoperative appearance of the patient in the photo above who sustained canalicular laceration following a motor vehicle accident.
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Woman with tearing and medial canthal asymmetry after the repair of a laceration sustained during a domestic assault. An emergency room physician performed the repair.
