Lacrimal tract trauma: Epidemiological aspects and prognostic factors in a population of southern Tunisia.

Introduction . The epidemiology and management of lacrimal tract trauma (LTT) vary depending on the populations, the skills, and resources of the healthcare team. Aim . To examine the epidemiological and therapeutic aspects of LTT and their prognostic factors in southern Tunisia. Methods . The study included 35 patients with LTT treated in the ophthalmology department of the Habib Bourguiba Hospital in Sfax. The postoperative result was evaluated functionally, anatomically, and aesthetically, and classified as good, average, or poor. Results . Patients were aged 28±18 years, with a sex ratio of 3.4. Domestic and road accidents and fights represented 93% of the causes of LTT. The lesions affected more frequently both the left side (71%) and the inferior canaliculus (74%). Most patients (91%) were operated on within the first 48 hours. The internal fragment was identified by the Bowman probe (in 83% of cases) and sutured in all patients with true monocanalicular intubation by mini-Monoka probe in 94% of cases. The post-operative result was good in 83% of patients. Younger age, loss of eyelid substance, delay in surgical intervention, and lacrimal suture without intubation were associated with unsatisfactory postoperative results. Conclusions . LTT affects mostly young male adults. Age under 20 years, post-traumatic operative delay above 48 hours, loss of eyelid substance, as well as suture of the wound without intubation are the main risk factors for a poor postoperative result. Good awareness and respect for the means of protection would make it possible to reduce LTT and their harmful impact.