1
|
Oliver-Gutiérrez D, Oliveres J, Segura-Duch G, Arnaiz A, Ros-Sanchez E, Alonso T. Functional inferior canalicular reconstruction using a monocanalicular probe after tumor resection of the medial third of the lower eyelid. J Fr Ophtalmol 2024; 47:104236. [PMID: 38880038 DOI: 10.1016/j.jfo.2024.104236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/11/2024] [Accepted: 01/26/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE To describe a surgical technique for functionally reconstructing a lacrimal drainage duct and to assess its long-term functionality. METHODS This observational review includes six cases involving reconstruction of the inferior canaliculus after surgical resection of lower eyelid carcinoma. Following lesion excision with safety margins, the epithelium of the distal portion of the inferior canaliculus is located and intubated with a monocanalicular probe. Subsequently, the eyelid lamellae are reconstructed without displacing the probe. The Monoka collarette is then sutured using a 10/0 nylon suture. Data collection included anatomic pathology of the lesion and data from ophthalmic examinations at each visit (including epiphora, inferior canalicular irrigation, and fluorescein dye disappearance test [FDDT]), as well as stent extrusion or other complications. RESULTS No complications were observed during the surgeries. The stents remained in place for an average of 4months, with no extrusions prior to removal. The mean follow-up period was 4.8years (SD=2.0), during which no other complications were noted. Only one patient experienced intermittent epiphora, also present in the fellow eye. At the final visit, FDDT was normal in all eyes, and all patients demonstrated patency of the inferior canaliculus upon irrigation. CONCLUSION Primary reconstruction of an inferior lacrimal drainage duct following tumor resection can be successfully performed, resulting in favorable functional recovery.
Collapse
Affiliation(s)
- D Oliver-Gutiérrez
- Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron 129, 08035 Barcelona, Spain; Innova Ocular Verte Barcelona, Vía Augusta 61, 08006 Barcelona, Spain.
| | - J Oliveres
- Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron 129, 08035 Barcelona, Spain
| | - G Segura-Duch
- Centro Oftalmológico Barraquer, Carrer de Muntaner 314, 08021 Barcelona, Spain; Innova Ocular Verte Barcelona, Vía Augusta 61, 08006 Barcelona, Spain
| | - A Arnaiz
- Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron 129, 08035 Barcelona, Spain
| | - E Ros-Sanchez
- Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron 129, 08035 Barcelona, Spain
| | - T Alonso
- Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron 129, 08035 Barcelona, Spain
| |
Collapse
|
2
|
Ducasse A, Larré I. [Lacrimal system trauma]. J Fr Ophtalmol 2024; 47:104076. [PMID: 38368761 DOI: 10.1016/j.jfo.2024.104076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/12/2023] [Indexed: 02/20/2024]
Abstract
Among lacrimal system injuries, canalicular lacerations are at the top of the list. Men are more affected than women, but children are most likely to experience such trauma. The cause depends on the patient's age: in young children, there is a higher prevalence of animal bites (dogs and cats); in young adults, fights predominate, since motor vehicle accidents have become less common; in the elderly, falls are among the most frequent causes. Tetanus vaccination is required in all cases, but assessment for rabies exposure is necessary in the case of dog or cat bites. Diagnosis is very simple: it is based on examination or wound probing. Other head, facial, or ocular injuries must be excluded; for example, an injury to the globe must take precedence over a canalicular laceration. In the absence of an ocular injury, the canalicular wound should be managed surgically within 48hours under an operating microscope: identification of both severed ends of the injured canaliculus, suture of the severed canaliculus with monofilament suture, and appropriate lacrimal intubation if indicated. Other trauma to the lacrimal system, such as sharp or blunt trauma to the lacrimal sac or nasolacrimal duct, are much rarer.
Collapse
Affiliation(s)
- A Ducasse
- 11, impasse de la Christoflerie, 24200 Marcillac-Saint-Quentin, France.
| | | |
Collapse
|
3
|
Chiu SJ, Currie ZI, Tan JH. Holding back the tears: is there a role for marsupialisation? BMJ Open Ophthalmol 2022; 7:bmjophth-2022-000985. [PMID: 36161857 PMCID: PMC9389104 DOI: 10.1136/bmjophth-2022-000985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 06/02/2022] [Indexed: 11/30/2022] Open
Abstract
Objective Medial eyelid tumours may result in the loss of the proximal lacrimal system during staged excision and delayed reconstruction, to achieve tumour margin clearance. The remnant canaliculus was marsupialised during reconstruction. The aim was to understand how many patients experienced symptomatic epiphora as a consequence of this. Methods and analysis A retrospective study including patients over a 15-year period with medial eyelid tumours, where the proximal lacrimal system was sacrificed to achieve tumour margin clearance. Included were all who had marsupialisation of the remnant distal stump as part of their delayed reconstruction. All who had pre-existing epiphora were excluded. The primary objective was the rate of epiphora following the procedure. A systematic literature review of postoperative epiphora occurring in patients with lid tumours requiring lacrimal system injury/sacrifice during tumour excision. Results There were 22 eyes (22 patients). All were basal cell carcinomas except for 1 (4.5%) tarsal conjunctival squamous cell carcinoma. All cases involved the lower lid. There were two (9.1%) patients who developed epiphora. One patient underwent a superior three-snip punctoplasty, botulinum toxin to the lacrimal gland and conjunctivodacryocystorhinostomy with Lester Jones tube insertion. The other patient was not overly troubled and did not require further treatment. The literature review showed the median postoperative rate of epiphora in these patients was 12.5% (range 0%–100%). Conclusion Marsupialisation of the remnant canaliculus during delayed reconstruction is a straightforward and effective surgical option, which may help prevent postreconstruction epiphora when the proximal lacrimal system is sacrificed for tumour margin clearance. Trial registration number 10391.
Collapse
Affiliation(s)
- Stephanie J Chiu
- Ophthalmology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Zanna I Currie
- Ophthalmology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Jennifer Hy Tan
- Ophthalmology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| |
Collapse
|
4
|
|
5
|
Karaca U, Genc H, Usta G. Canalicular laceration (cheese wiring) with a silicone tube after endoscopic dacryocystorhinostomy: when to remove the tube? GMS OPHTHALMOLOGY CASES 2019; 9:Doc35. [PMID: 31728262 PMCID: PMC6848888 DOI: 10.3205/oc000124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objective: To discuss the removal time of a nasolacrimal silicone tube stent by reporting three cases with canalicular laceration due to prolonged indwelling of the stent. Methods: This study involved three cases of nasolacrimal duct obstruction treated by endoscopic dacryocystorhinostomy with silicone tube insertion. Results: The mean indwelling time of the silicone tube was 9.3 months and all of the patients had lower canalicular laceration near the common canaliculus. One patient presented with a complaint of canthal pain, blurred vision, and epiphora while the other two patients reported no complaint. The nasal endoscopic examination revealed a narrow fibrotic ostium below the medial concha. The silicone tubes were removed. Conclusions: To increase the success rate of the operation, the removal time for nasolacrimal silicone tubes after dacryocystorhinostomy is also important. Our findings indicate that physicians should be aware of the potential problems related to prolonged intubation.
Collapse
Affiliation(s)
- Umut Karaca
- Isparta Suleyman Demirel University, Faculty of Medicine, Department of Ophthalmology, Isparta, Turkey.,Gulhane Military Medical Academy, Department of Ophthalmology, Ankara, Turkey
| | - Hakan Genc
- Gulhane Military Medical Academy, Department of ENT, Ankara, Turkey
| | - Gulsah Usta
- Isparta Suleyman Demirel University, Faculty of Medicine, Department of Ophthalmology, Isparta, Turkey.,Kırıkkale University, Department of Ophthalmology, Kırıkkale, Turkey
| |
Collapse
|
6
|
Kalin-Hajdu E, Cadet N, Boulos PR. Controversies of the lacrimal system. Surv Ophthalmol 2016; 61:309-13. [DOI: 10.1016/j.survophthal.2015.12.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Revised: 12/04/2015] [Accepted: 12/07/2015] [Indexed: 01/22/2023]
|
7
|
|
8
|
Microscope-Assisted Reconstruction of Canalicular Laceration Using Mini-Monoka. J Craniofac Surg 2013; 24:2056-8. [DOI: 10.1097/scs.0b013e3182a14b38] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
9
|
Comparing pericanalicular sutures with direct canalicular wall sutures for canalicular laceration. Ophthalmic Plast Reconstr Surg 2012; 27:422-5. [PMID: 21697757 DOI: 10.1097/iop.0b013e31822113df] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine whether a statistically significant difference exists between direct canalicular wall sutures (DCs) and pericanalicular sutures (PCs) in the repair of traumatic canalicular lacerations. METHODS The medical records of 63 patients who underwent primary repairs for traumatic canalicular lacerations were retrospectively reviewed. Patients were divided in 2 groups according to the suturing techniques used: the DC group (n = 41) and the PC group (n = 22). Anatomic results were compared between these 2 groups. A successful result was determined by attempted irrigation and probing of the injured canaliculus at the last follow-up visit. RESULTS There were 6 failed procedures among the patients who underwent pericanalicular repair and 1 failed procedure among the patients who underwent direct canalicular wall repair (p = 0.024). CONCLUSIONS These data support the higher success rates in patients treated with direct canalicular repair compared with pericanalicular repair.
Collapse
|
10
|
Rosser PM, Burt B, Osborne SF. Determination of the function of a repaired canaliculus after monocanalicular injury by placing a punctal plug in the non-involved punctum on the affected side. Clin Exp Ophthalmol 2010; 38:786-9. [DOI: 10.1111/j.1442-9071.2010.02330.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
11
|
Analysis of bicanalicular nasal intubation in the repair of canalicular lacerations. Jpn J Ophthalmol 2010; 54:24-31. [DOI: 10.1007/s10384-009-0755-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2009] [Accepted: 09/01/2009] [Indexed: 11/26/2022]
|
12
|
Lee H, Chi M, Park M, Baek S. Effectiveness of canalicular laceration repair using monocanalicular intubation with Monoka tubes. Acta Ophthalmol 2009; 87:793-6. [PMID: 20849564 DOI: 10.1111/j.1755-3768.2009.01644.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed to evaluate the clinical efficacy of canalicular laceration repair using monocanalicular intubation with Monoka tubes. METHODS A total of 36 single lacerated canaliculi were repaired using monocanalicular intubation with Monoka tubes, without mucosal anastomosis of the canaliculi, and were retrospectively reviewed. Demographic information, injury locations, associated ocular injuries, complications and outcomes were analysed. RESULTS Mean patient age was 34 years (range 1-64 years). Tubes were removed at a mean of 4.2 months (range 3-6 months). There were 26 lower canalicular lacerations (72%) and 10 upper canalicular lacerations (28%). Overall, 34 of 36 cases (92%) showed improvement in symptoms and exhibited positivity on the dye disappearance test at 4-12 months after the procedure (mean 7.8 months). In total, 21 patients (58%) achieved complete success, 13 patients (36%) achieved partial success and two patients (6%) suffered surgical failure. Complications were seen in five cases and included two early tube protrusions, two punctal slits and one punctal granuloma. CONCLUSIONS Monocanalicular intubation with Monoka tubes leads to successful outcomes without significant complications and offers an alternative to bicanalicular intubation in the treatment of monocanalicular lacerations.
Collapse
Affiliation(s)
- Hwa Lee
- Department of Ophthalmology, College of Medicine, Korea University, Seoul, Korea
| | | | | | | |
Collapse
|
13
|
Kim OJ, Ko BY, Kim SJ, Ha MS. Clinical Features Associated With Outcomes of Canalicular Laceration Repair. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2009. [DOI: 10.3341/jkos.2009.50.1.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Oh Jae Kim
- Department of Ophthalmology, KonYang University College of Medicine, Daejon, Korea
| | - Byung Yi Ko
- Department of Ophthalmology, KonYang University College of Medicine, Daejon, Korea
| | - Sung Joo Kim
- Department of Ophthalmology, KonYang University College of Medicine, Kim's Eye Hospital, Seoul, Korea
| | - Myung Sook Ha
- Department of Ophthalmology, KonYang University College of Medicine, Daejon, Korea
| |
Collapse
|
14
|
The round-tipped, eyed pigtail probe for canalicular intubation: a review of 228 patients. Ophthalmic Plast Reconstr Surg 2008; 24:176-80. [PMID: 18520830 DOI: 10.1097/iop.0b013e31816b99df] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess the effectiveness and outcomes of canalicular intubation with the use of a round-tipped, eyed pigtail probe. METHODS Retrospective interventional case series of 228 patients requiring intubation of the canalicular system. Patients were treated surgically with attempted repair of the canalicular system with the round-tipped, eyed pigtail probe. The main outcome measures were successful intubation of the lacrimal system, symptoms of tearing, clinical functional evaluation of lacrimal system, complications, and need for further lacrimal surgery. RESULTS Of 228 patients, 222 (97.4%) had their canalicular systems successfully intubated with silicone tubing using the round-tipped, eyed pigtail probe. Follow-up was obtained in 191 (86%) of the 222 patients. One-hundred sixty of 191 (83.8%) patients were irrigated and found to be anatomically patent (of the remainder, one was blocked whereas 30 were too young to be irrigated). One hundred fifty-two of the 191 (79.6%) patients had no tearing by history. Thirty-two (16.7%) had occasional tearing on some days that was not bothersome. Seven (3.7%) had intermittent or persistent tearing on a daily basis. Sixty-seven of the 191 (35%) had their lacrimal system more extensively assessed using the dye disappearance test, Jones I test, Jones II test, and canalicular probing. Anatomic patency in this subgroup was demonstrated in 66 of 67 (98.5%) of patients. The dye disappearance test, however, revealed slight asymmetry in 24 of 53 patients (45%) with canalicular lacerations yet only 14 of these 24 (58%) had any symptoms of tearing, indicating some discrepancy between subjective and objective assessment of tearing postcanalicular repair. Fifty-three of the repaired trauma patients underwent probing of the involved and uninvolved canalicular systems. In no patient was a stricture or blockage involving the uninvolved canaliculus identified. Additional lacrimal surgery (dacryocystorhinostomy) was performed on 2 of 191 (1%) patients with greater than 3 months follow-up. CONCLUSION The round-tipped, eyed pigtail probe can help safely and effectively identify and repair canalicular lacerations. Symptomatic tearing was infrequent; the lacrimal systems showed complete anatomic patency in the majority of patients tested, and need for further lacrimal surgery was rare following pigtail probe intubation.
Collapse
|
15
|
Naik MN, Kelapure A, Rath S, Honavar SG. Management of canalicular lacerations: epidemiological aspects and experience with Mini-Monoka monocanalicular stent. Am J Ophthalmol 2008; 145:375-380. [PMID: 18061134 DOI: 10.1016/j.ajo.2007.09.018] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2007] [Revised: 09/10/2007] [Accepted: 09/12/2007] [Indexed: 10/22/2022]
Abstract
PURPOSE To report the epidemiological data, clinical profile, and surgical outcome of canalicular lacerations in an Indian population. DESIGN Retrospective interventional case series. METHODS All patients who underwent canalicular laceration repair from July 1, 2002 to June 30, 2005 at a tertiary eye care center were retrospectively reviewed. Demographics, cause of eyelid injury, associated ocular injury, surgical management with Mini-Monoka monocanalicular stent, and its outcome were analyzed. RESULTS Sixty-six patients underwent eyelid laceration repair, of which 24 (36%) had involvement of the canalicular system. The mean age at presentation was 16 years (range, 10 months to 52 years); 20 (83.3%) patients were males. Mode of injury included the blouse-hook fastener in five (20.8%) breast-feeding infants, bicycle handle injury in four (16.7%) children, and metal rod injury in five (20.8%) adults. Lower canaliculus was involved in 13 (54.1%), upper in eight (33.3%), and both in three (12.5%) patients. Simultaneous globe injury was noted in six (25%) patients, five (83.3%) of which had upper canalicular involvement. Twenty-seven canalicular lacerations (24 patients) underwent stenting with the Mini-Monoka monocanalicular stent. Three (11.1%) stents extruded within one month. At the final follow-up (mean, 18.5 months), canalicular block was noted in two (10%) out of 20 patients; none had epiphora. CONCLUSION Canalicular involvement occurs in 36% of eyelid injuries. Injury by the "blouse-hook fastener" is unique to infants in the Indian context. Simultaneous globe injury is present in 25% of cases, especially when the upper canaliculus is involved. Mini-Monoka stent extrusions occur within one month. With an 11.1% extrusion rate, Mini-Monoka stents achieved good anatomical (90%) and functional (100%) success in the management of canalicular injury.
Collapse
|
16
|
Murgatroyd H, Craig JP, Sloan B. Determination of relative contribution of the superior and inferior canaliculi to the lacrimal drainage system in health using the drop test. Clin Exp Ophthalmol 2004; 32:404-10. [PMID: 15281976 DOI: 10.1111/j.1442-9071.2004.00846.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE The aim of this study was to explore the use of the 'drop test' as a method of assessing maximal lacrimal outflow capacity, and to measure the relative contribution of the superior and inferior canaliculi to the drainage capacity in normal subjects. METHOD The drop test involves instilling measured aliquots of normal saline over 3-min periods to raise the tear lake medially. Both eyes were assessed; however, for the right lacrimal drainage system only, sequential insertion and then removal of silicone punctal plugs was performed. After each stage the maximal lacrimal drainage capacity was measured. no punctal plugs were placed in the puncta on the left side. RESULTS Complete data were collected from 20 subjects with a mean age of 35.6 years. The intraclass correlation coefficient for the five left eye readings was 0.98 (CI 0.96-0.99) and the limits of agreement of a single reading were -22.6 to +93.0 micro L/3 min. Without intervention, no statistically significant difference was found in the mean lacrimal outflow between the left and right eyes (P = 0.16). A statistically significant reduction in outflow resulted from punctal occlusion (P < 0.05). Presenting the proportion of lacrimal outflow as a percentage of the combined values of the superior and inferior canaliculi, 59.9% of outflow occurred through the inferior canaliculus. CONCLUSION The drop test was found to provide a simple and repeatable method of assessing lacrimal drainage in a minimally invasive manner in the clinical setting. In healthy volunteers in the supine position 60% of maximal lacrimal outflow capacity occurs through the inferior canaliculus.
Collapse
Affiliation(s)
- Helen Murgatroyd
- Department of Ophthalmology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | | | | |
Collapse
|
17
|
Abstract
Conflicts between specialties abound in problems of the periorbita with different specialties claiming expertise in this area. These conflicts include both the diagnosis and the treatment of oculoplastic problems. Cases are presented in which such conflicts have arisen leading to less than optimal care for the patients. Engendering these conflicts are the Managed Care fiats of both insurance companies and hospital territorial conflicts. Ideas are presented for the ethical resolution of both the physician conflicts and for the recognition that managed care induced conflicts lead ultimately to less than optimal care.
Collapse
Affiliation(s)
- Joshua Frankel
- Eye Care Specialists of NEPA, Kingston, Pennsylvania, USA
| |
Collapse
|
18
|
Affiliation(s)
- Morris E Hartstein
- Department of Ophthalmology, Saint Louis University Eye Institute, MO 63104, USA
| | | |
Collapse
|
19
|
Jordan DR. Monocanalicular lacerations: to reconstruct or not? CANADIAN JOURNAL OF OPHTHALMOLOGY 2002; 37:245-6. [PMID: 12095098 DOI: 10.1016/s0008-4182(02)80116-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
20
|
Hsu HC, Lin SA, Lin HF. Pyogenic granuloma as a rare complication of silicone stent after canalicular injury. THE JOURNAL OF TRAUMA 2001; 51:1197-9. [PMID: 11740277 DOI: 10.1097/00005373-200112000-00031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- H C Hsu
- Department of Ophthalmology, Chang Gung University, Chang Gung Memorial Hospital, Niao-Sung Hsiang, Kaohsiung, Taiwan.
| | | | | |
Collapse
|
21
|
Smit TJ, Mourits MP. Author’s reply. Ophthalmology 2000. [DOI: 10.1016/s0161-6420(00)00065-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|