Primary and secondary transconjunctival involutional entropion repair
36
Citation
41
Reference
10
Related Paper
Citation Trend
Keywords:
Entropion
Retractor
Trichiasis
Ectropion
Entropion
Retractor
Trichiasis
Ectropion
Cite
Citations (36)
Purpose The aim was the comparison of two different approaches to re-insert the inferior eyelid retractors within addition to lateral tarsal strip at lower eyelid involutional entropion (LEIE) surgical correction. Method This multicentric retrospective case series involved 233 consecutive patients (195 eyelids) who underwent LEIE repair. All the lids had a lateral tarsal strip (LTS) in addition to the reinsertion of retractors onto the tarsal plate via the anterior approach (group 1) or the posterior approach (group 2). The desired normal position of the eyelids at 6-month follow-up was considered ‘surgical successes, while entropion recurrence and overcorrection (ectropion) were considered ‘surgical failures’. Results One-hundred ninety-one (82%) surgeries were included in group 1 and 42 (18%) in group 2. The success rate was 92.1% (176 lids) in group 1 and 85.7% (36 lids) in group 2 (p = 0.188). The recurrence rate was statistically higher for group 2 (14.3%) than for group 1 (3.7%) (p = 0.016). Overcorrection only described in group 1 (3.1%). Both groups had a similar complication rate (p = 0.268), with trichiasis being the most frequent (14, 6%). Ten eyelids (47.6%) from the 21 overall failures were satisfactorily reoperated, and the remaining ones were treated conservatively. Conclusion The anterior or posterior approach to reinsert lower eyelid retractors to tarsal plate in addition to LTS to correct LEIE can provide a similar outcome. However, the anterior approach achieves a slightly higher success rate with fewer recurrences but with a higher overcorrection rate.
Retractor
Entropion
Cite
Citations (0)
INTRODUCTION
The eye is one of the delicate organs in the body. It is situated within
the bony orbit and is protected by the walls of the orbit. The eyelids are the
important structures that protect the eyeball apart from the orbit. The eyelid
malpositions are of a common occurrence now a days. Meticulous repair of
these malpositions is essential for restoration of eyelid form and function. A
detailed knowledge of the eyelid anatomy is essential for the surgeon to be
able to achieve a good repair. Various surgical modalities are available for the
correction of the eyelid malpositions such as ectropion and entropion. We
shall have a overview of the eyelid anatomy and its malpositions in this thesis
work.
AIM OF THE STUDY: To analyse the incidence of different types of ectropion and entropion
To analyse the various clinical presentations of ectropion and entropion
To analyse the various surgical procedures and also to find out the
procedures which can be easily performed even by a general
ophthalmologist in the correction of ectropion and entropion.
To assess the outcome of surgical repair of ectropion and entropion
MATERIALS AND METHODS:
This study was conducted at the Regional Institute of Ophthalmology
and Govt. Ophthalmic Hospital, Egmore, Chennai from Jan 2005 to March
2006 for a period of 15 months. The patients presenting to the OPD with
ectropion and entropion especially needing the surgical repair were taken
up for the study. Inclusion Criteria:
1. Various clinical patterns of ectropion and entropion.
2. Presentation with trichiasis and distichiasis.
SUMMARY: • Males were involved in 56% of the cases. Females were involved in 44% of the cases.
81% of the affected patients were in the age group of > 50yrs. 17% of
the affected patients were between 10-50yrs. 2% were < 10yrs
72% of the reported cases were ectropion. 28% of the cases were
Entropion.
RESULTS AND ANALYSIS: Out of the different presentations of ectropion, the involutional type
was found to be the commonest presentation. The commonly performed
surgical procedure for involutional type of ectropion was the lateral
strip procedure. The outcome of the surgery was good in almost all the
cases.
CONCLUSION: Ectropion and entropion of the lids is more or less equally distributed in both the sex. Most of the affected patients were above 50 yrs. It shows that involutional type of ectropion and entropion is more common.
Entropion
Ectropion
Trichiasis
Orbit (dynamics)
Cite
Citations (0)
Entropion
Ectropion
Retractor
Blepharoplasty
Cite
Citations (0)
To evaluate the effectiveness of full-thickness skin graft adhesion using fibrin tissue glue (TISSEEL) in cicatricial ectropion repair of the lower eyelid.This study was a prospective case series. Nine eyes of 8 consecutive patients with cicatricial ectropion were included. All patients underwent a conjunctival approach lower eyelid retractor plication, lateral tarsal strip, and insertion of a full-thickness skin graft secured with TISSEEL. Symptoms of epiphora, eye and eyelid irritation, discharge, and graft size were recorded pre- and postoperatively.All of the patients were satisfied with their postoperative appearance, and the symptoms of eye and eyelid irritation, discharge, and visual disturbance were eliminated. Fifty-five percent of patients had complained of watering some or all of the time preoperatively, whereas only 33% admitted to occasional watering postoperatively. The average size of the graft reduced by 18% at 1 week, 39% at 1 month, and 40% at 3 months from the initial size.Fibrin tissue glue used to attach a full-thickness skin graft during cicatricial ectropion repair is an effective technique and may offer additional benefits over sutured graft fixation. Most of the reduction in graft size occurred in the first postoperative month, which indicates that the time window for modulation of the graft is in the first few weeks after surgery. The vertical graft length was affected to a greater extent than the horizontal length.
Ectropion
Entropion
Retractor
Cite
Citations (9)
Purpose: To evaluate the long-term effectiveness of different surgical procedures according to horizontal eyelid laxity in correcting involutional entropion. Methods: This retrospective study reviewed 104 eyes of 79 patients with involutional lower eyelid entropion who underwent surgical repair. The 62 eyes with horizontal eyelid laxity were classified as group I. In 17 eyes of group I, we performed the lateral tarsal strip procedure alone (group Ia), while in 45 eyes of group I, we performed the lateral tarsal procedure and Quickert suture (group Ib). The 42 eyes without horizontal eyelid laxity were classified as group II. In 13 eyes of group II, we performed a lower eyelid retractor reinsertion procedure only (group IIa), and in 29 eyes of group II, we performed combined lower eyelid retractor reinsertion and orbicularis resection (group IIb). Results: The recurrence rate in these four surgical subsets (group Ia , group Ib, group IIa, group IIb) was 11.7%, 0%, 15.4%, and 6.9%, respectively, with an average follow-up of 11 months. Six recurrent eyelids and two overcorrected eyelids successfully underwent procedures to correct recurrent entropion and ectropion, respectively. Conclusions: The lateral tarsal strip procedure is an effective approach for achieving long-lasting correction of involutional entropion with horizontal eyelid laxity, whereas the lower eyelid retractor reinsertion procedure is an effective approach for achieving long-lasting correction for involutional entropion without horizontal eyelid laxity. Use of the Quickert suture reduced the need to repeat the lateral tarsal strip procedure and additional orbicularis resection decreased the need to repeat the lower eyelid retractor reinsertion procedure.
Entropion
Retractor
Ectropion
Blepharoplasty
Cite
Citations (4)
Lower-eyelid tarsal ectropion is an unusual form of eyelid malposition in which the entire lid is everted. The cause is most likely the disinsertion of the lower-eyelid retractors. In 12 eyelids of six patients, a transconjunctival approach was used to reunite the retractors with the inferior tarsal border. In eight eyelids, a horizontal tightening procedure was also needed. The looping passage of fornix sutures through the full thickness of the eyelid created a vector force that helped rotate the lid margin inward. The subsequent formation of an inflammatory cicatrix induced by the absorbable sutures also contributed to maintain the lid in an upright posture. During follow-up periods ranging from 8 to 36 months, there were no instances of overinversion, recurrent ectropion, or suture abscess.
Ectropion
Tarsus (eyelids)
Eyelid Diseases
Retractor
Trichiasis
Entropion
Blepharoplasty
Eyelash
Cite
Citations (41)
Purpose: We studied the surgical outcome and efficacy of transconjunctival repair for involutional entropion. Patients and method: We retrospectively analyzed a total of 20 eyelids of 19 patients with involutional entropion from March 1998 to December 2001. There were 10 male and 9 female patients with the mean age of 70 years. It included 2 recurred cases of unknown original surgical procedure. The conjunctiva was cut and opened by monopolar cautery and the conjunctival flap was carefully dissected. Disinserted or attenuated lower lid retractor was fixed by interrupted sutures on anterior part of tarsus. In all patients, full-thickness everting mattress sutures including conjunctiva and lower lid retractor were applied. Lateral tarsal strip procedure was added to 12 (60%) eyelids having serious horizontal laxity. Results: Capsulopalpebral fascia was found to be disinserted in 18 eyelids (90%) intraoperatively. Mean follow-up period was 14.1 months (2-24 months). There was no postoperative complication except 1 patient having filamentary keratitis. There Was recurrence of entropion in 1eyelid (5%) at 2months. Conclusions: The transconjunctival repair for involutinal entropion is simple and effective without significant complication. The procedure averts the postoperative morbidity, scar of the eyelid and shortens operative time.
Entropion
Retractor
Cite
Citations (1)
Hintergrund: In Anbetracht der Entwicklung der Alterspyramide ist mit einer weiteren Zunahme insbesondere senil bedingter Lidfehlstellungen zu rechnen. Methoden: Vorgestellt werden anhand von Patientenbeispielen die gebräuchlichsten operativen Verfahren zur Korrektur von Entropium, Ektropium, Trichiasis, Ptosis sowie den Lidanomalien bei Fazialisparese und Postenukleationssyndrom. Ergebnisse: Prinzipiell lassen sich die meisten Lidfehlstellungen mit sehr gutem kosmetischem und funktionellem Ergebnis korrigieren. Problematisch sind solche, die im Rahmen von kongenitalen Anomalien und systemischen Erkrankungen auftreten. Schlussfolgerung: Die Wahl des operativen Vorgehens unter Berücksichtigung des Alters des Patienten, der Genese und der genauen Lokalisation der Pathologie sind für ein ideales postoperatives Ergebnis von außerordentlicher Bedeutung.
Trichiasis
Cite
Citations (1)
There is a paucity of data in the literature on the surgical management of lower eyelid marginal entropion. In this study, the authors report outcomes of a surgical technique of eyelid margin splitting and anterior lamellar reposition in patients with lower eyelid marginal entropion.The medical records for 30 eyelids from 22 patients with lower eyelid marginal entropion who had undergone eyelid margin splitting and anterior lamellar repositioning at Seoul National University Hospital from January 2004 to December 2012 were retrospectively reviewed. Success was defined as the lack of any lash in contact with the globe, no need for a second procedure, the complete resolution of symptoms, and acceptable cosmesis at the final follow up.The mean follow-up duration was 16.7 months. The split eyelid margin exhibited good wound healing in each case, but trichiasis recurred postoperatively in 3 of 30 eyelids, even though the eyelid margin was ultimately well positioned. That is, the overall success rate was 90%. Of the 3 eyelids with recurrent trichiasis, 2 required additional electrolysis to remove irritated cilia, but the other did not require to be treated. In the latter case, the trichiasis observed was fine, focal, and unaccompanied by symptoms or corneal lesions. There was no significant complication such as secondary ectropion or eyelid retraction.Eyelid margin splitting and anterior lamellar repositioning achieve success with a low rate of complications among patients with lower eyelid marginal entropion.
Entropion
Trichiasis
Cosmesis
Ectropion
Margin (machine learning)
Cite
Citations (14)