Abstract:

Objective To analyze the effect of probe localization of lacrimal passage combined with artificial lacrimal duct implantation in traumatic lacrimal canaliculi rupture and the factors affecting the surgical effect. Methods A total of 141 patients with traumatic lacrimal canaliculus rupture from January 2022 to December 2024 were selected. Another 34 patients with the same disease admitted from January to August 2025 were selected for internal validation of the model. All patients underwent lacrimal duct probe localization method combined with artificial lacrimal duct implantation. The surgical efficacy and postoperative complications were analyzed. According to the follow-up results at 6 months after surgery, patients were divided into the unobstructed group and the blocked group. The factors affecting the surgical effect were analyzed, and a prediction model was constructed. The predictive efficacy of the model was evaluated using the receiver operating characteristic (ROC) curve. Results Ninety-six patients were cured, 38 improved, and the clinical effective rate was 95.04%, with a complication rate of 7.80%. After 6 months of follow-up, there were 108 patients in the unobstructed group and 33 patients in the obstruction group. No long-term complications such as late displacement of the stent, formation of granulation tissue, or restenosis were observed. Compared with the unobstructed group, the blocked group had a higher incidence of proximal fracture, a longer time from injury to seeking medical treatment (≥ 24 hours), and a higher proportion of complete fractures. The indwelling tube time was shorter (P<0.05). Multivariate Logistic regression analysis showed that the fracture site being proximal, complete fracture and the time of visit being ≥ 24 hours were risk factors affecting the surgical outcome of the patients, while a longer catheter retention time was a protective factor for the surgical outcome of patients (P<0.05). The area under the curve (AUC) of the prediction model based on these indicators for predicting the surgical effect of patients was 0.830 (95%CI: 0.751-0.909), with a sensitivity of 84.80% and a specificity of 74.10%, and the internal validation model accuracy rate was 88.24%. Conclusion The prediction model of the lacrimal duct probe localization method combined with artificial lacrimal duct implantation for traumatic lacrimal canaliculus rupture constructed in this study can provide individualized surgical risk stratification and prognosis assessment tools for clinicians.

Key words: lacrimal apparatus, lacrimal passage probe positioning method, artificial lacrimal duct implantation, traumatic lacrimal canaliculus rupture, surgical effect