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Vaidyanathan A, Hariprasad CP. Re: Ageing increases risk of lower eyelid malposition after primary orbital fracture reconstruction. Br J Oral Maxillofac Surg 2023; 61:188. [PMID: 36653240 DOI: 10.1016/j.bjoms.2022.11.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 11/06/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Aiswarya Vaidyanathan
- All India Institute of Medical Sciences - Patna, Phulwarisharif, Patna, Bihar 801507, India.
| | - C P Hariprasad
- All India Institute of Medical Sciences - Patna, Phulwarisharif, Patna, Bihar 801507, India
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AlHarthi AS. Involutional ectropion: etiological factors and therapeutic management. Int Ophthalmol 2022; 43:1013-1026. [PMID: 36053479 DOI: 10.1007/s10792-022-02475-3] [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: 05/07/2022] [Accepted: 08/20/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE Involutional Ectropion is commonly prevalent disorder of eyelid malposition caused by age-related degeneration of the periocular tissues. This study conducted to provide a summary and review of surgical practice for the management of lower eyelid involutional ectropion and enlist various causative factors that explain the pathogenesis. METHODS The review of literature on risk factors and surgical approaches for involutional lower eyelid ectropion, searched on PubMed from 1980 onwards. RESULT Multiple factors contribute to horizontal and vertical lower eyelid involutional ectropion. Several surgical practices have been described over the last years to address these factors. Lateral tarsal strip is the most used and effective surgery to treat horizontal laxity. CONCLUSION Knowledge of various contributing factors and surgical procedures will enable to design the most effective therapeutic management for lower eyelid involutional ectropion. surgical approaches are individualized depending on preoperative clinical evaluation of possible causative factors and concerning the predominant location of the ectropion will result in a high success rate.
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Affiliation(s)
- Abdulaziz S AlHarthi
- Ophthalmology Department, College of Medicine, Majmaah University, 11952, Al-Majmaah, Saudi Arabia.
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Using A Modified Quickert Procedure Combined with Prolapsed Fat and Preseptal Orbicularis Muscle Removal to Correct Involutional Lower Eyelid Entropion in Asians. Biomed J 2022; 46:100543. [DOI: 10.1016/j.bj.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 05/27/2022] [Accepted: 05/29/2022] [Indexed: 11/24/2022] Open
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Garip R, Meriç P, Özveren M, Özveren N. Evaluation of Orbit Vector Relationships in Different Types of Skeletal Malocclusions. MEANDROS MEDICAL AND DENTAL JOURNAL 2022. [DOI: 10.4274/meandros.galenos.2021.56933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Lee H, Cha E, Baek S. Outcomes of Lateral Tarsal Strip in Conjunction with a Minimal Skin Muscle Excision Underlying Cauterization in Korean Patients with Involutional Entropion. Front Surg 2022; 9:870751. [PMID: 35647003 PMCID: PMC9133528 DOI: 10.3389/fsurg.2022.870751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/21/2022] [Indexed: 11/29/2022] Open
Abstract
We reviewed the medical records of 53 involutional entropion patients, who underwent lateral tarsal strip (LTS) with a minimal skin muscle excision by cauterization from March 2014 to December 2017, to evaluate the effectiveness and efficiency of LTS in conjunction with a minimal skin muscle excision using cautery in patients with involutional entropion. We evaluated the success rate, complications, recurrence rate, and degree of satisfaction of our technique. Of 53 patients, there were 5 bilateral cases for a total of 58 eyelids. The average of age was 71.2 years old (57–90 years). The average follow-up period was 18 months (12–39 months). The success rate for involutional entropion correction was 98.1% with our technique. There was one mild recurrence case at 7 months. In our study, the average operation time was 20.8 min (15–29 min) for 48 unilateral cases and 27.2 min (20–32 min) for 5 bilateral cases without intraoperative complications. Of 42 responders of patients’ satisfaction questionnaire, 38 patients showed good satisfaction and were willing to recommend the surgery to their acquaintances. The technique of LTS with minimal skin excision with cauterization was effective and provided satisfying outcomes to patients with involutional entropion.
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Affiliation(s)
- Hyunkyu Lee
- Department of Ophthalmology, Korea University College of Medicine, Ansan Hospital, Ansan, South Korea
| | - Eunhyang Cha
- Department of Ophthalmology, Korea University College of Medicine, Guro Hospital, Seoul, South Korea
| | - Sehyun Baek
- Department of Ophthalmology, Korea University College of Medicine, Guro Hospital, Seoul, South Korea
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Hu J, Li Y, Li Q, Wang L, Huang Y. A retrospective study of tailored surgery based on the mechanical balance principle for involutional entropion in the lower eyelid. Eur J Ophthalmol 2020; 31:3418-3424. [PMID: 33356531 DOI: 10.1177/1120672120984398] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Involutional entropion in the lower eyelid is one of the most common eyelid disorders of the elderly. Despite the effectiveness of the widely used surgical procedures, recurrence rates have failed to improve. In this retrospective study, we aimed to assess surgical plans, effectiveness and safety of tailored surgery based on the mechanical balance principal in treating involutional entropion in the lower eyelid. METHODS A retrospective analysis of 47 patients (54 eyelids) diagnosed with involutional entropion in the lower eyelid and receiving tailored surgical treatment based on mechanical balance principle from 1 January 2016 to 31 December 2018 was carried out. Tailored surgical plans were developed according to the mechanical balance analysis of vertical, horizontal and sagittal directions. RESULTS All 54 eyelids with involutional entropion in the lower eyelid underwent advancement of the lower eyelid retractor (LER) through the conjunctiva. For patients with mild horizontal eyelid laxity, only LER advancement was performed. For moderate and severe horizontal eyelid laxities, combined horizontal reinforcement procedures were performed, including lateral canthopexy, lateral tarsal strip (LTS) surgery and wedge resection. The orbicularis oculi muscle (OOM) tightening or transposition was performed for OOM overriding. The follow-up time was 1 to 4 years, and there were no cases experiencing recurrence. Thus, the rates of effectiveness and recurrence were 100% and 0%, respectively. CONCLUSIONS This is the first descriptive study on the tailored surgical strategies designed according to the mechanism of mechanical imbalance involved in involutional entropion. Tailored surgery based on the mechanical balance principle is safe and effective with low recurrence.
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Affiliation(s)
- Jian Hu
- Medical School of Chinese PLA, Haidian, Beijing, China.,Department of Ophthalmology, Chinese PLA General Hospital, Haidian, Beijing, China
| | - Yueyue Li
- Medical School of Chinese PLA, Haidian, Beijing, China.,Department of Ophthalmology, Chinese PLA General Hospital, Haidian, Beijing, China
| | - Qian Li
- Medical School of Chinese PLA, Haidian, Beijing, China.,Department of Ophthalmology, Chinese PLA General Hospital, Haidian, Beijing, China
| | - Liqiang Wang
- Medical School of Chinese PLA, Haidian, Beijing, China.,Department of Ophthalmology, Chinese PLA General Hospital, Haidian, Beijing, China
| | - Yifei Huang
- Medical School of Chinese PLA, Haidian, Beijing, China.,Department of Ophthalmology, Chinese PLA General Hospital, Haidian, Beijing, China
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Griffin MJ, Sims JR, Spaulding SL, Baik FM, Elahi E, Urken ML. Management of orbital complications in palatomaxillary reconstruction: A review of preemptive and corrective measures. Head Neck 2019; 42:556-568. [PMID: 31837075 DOI: 10.1002/hed.26015] [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: 05/31/2019] [Revised: 09/20/2019] [Accepted: 10/30/2019] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Reconstruction of orbit-sparing palatomaxillary defects requires consideration of globe dystopia, orbital volume, eyelid position and function, and the nasolacrimal system to preserve and optimize vision, globe protection, and appearance. We describe the fundamentals of orbital and eyelid anatomy, common orbital complications related to palatomaxillary reconstruction, and preemptive and corrective surgical techniques to be utilized during and after globe-sparing palatomaxillary reconstruction. METHODS We present a review of the literature supplemented by clinical case examples. RESULTS We advocate for the use of preemptive and corrective techniques to ensure optimal aesthetic and functional outcomes for patients with orbital defects. CONCLUSIONS Recognition and anticipation of problems in patients undergoing midface ablative and reconstructive procedures are vital to the implementation of corrective measures. Incision choice, orbital volume restoration, appropriate orbital floor reconstruction, and permanent or temporary lower eyelid suspension during the primary surgery can all significantly impact the development of long-term orbital complications.
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Affiliation(s)
- Martha J Griffin
- THANC (Thyroid, Head and Neck Cancer) Foundation, New York, New York
| | - John R Sims
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Beth Israel, New York, New York
| | - Sarah L Spaulding
- THANC (Thyroid, Head and Neck Cancer) Foundation, New York, New York
| | - Fred M Baik
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Beth Israel, New York, New York
| | - Ebrahim Elahi
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York.,Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Mark L Urken
- THANC (Thyroid, Head and Neck Cancer) Foundation, New York, New York.,Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Beth Israel, New York, New York
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Assessment of the Safety and Efficacy of Prolapsed Orbital Fat Resection During Involutional Entropion Repair. Ophthalmic Plast Reconstr Surg 2019; 36:34-37. [PMID: 31567912 DOI: 10.1097/iop.0000000000001452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess the recurrence rate of involutional entropion in patients treated with a combined approach including a modified Bick procedure, excision of preseptal orbicularis muscle, and conservative resection of prolapsed orbital fat. METHODS A retrospective chart review of patients undergoing repair of involutional entropion with the combined procedure including orbital fat resection and a second group with standard entropion repair without orbital fat resection was performed. Only patients with follow-up greater than 6 months were included in the study. RESULTS Seventy eyelids of 54 patients met all inclusion criteria for the combined procedure group over a 9-year period from 2008 to 2016. Average follow-up was 46.9 months. There was a documented recurrence of entropion in 1 eyelid during the follow-up period (1.4%). The remaining 69 cases had successful subjective and objective results without need for any additional procedures. In the group undergoing entropion repair without fat resection, 22 eyelids of 19 patients had the required follow-up period with a recurrence rate of 4.5% (p > 0.05). CONCLUSIONS The authors demonstrate good surgical success with a combined approach of a modified Bick procedure, preseptal orbicularis excision, and conservative orbital fat resection. Conservative fat resection during entropion repair was found to be safe, and the combined procedure was found to be effective with a rate of recurrent entropion of 1.4% on extended follow-up.The authors propose that orbital fat prolapse contributes to the mechanics of involutional entropion and that conservative orbital fat resection during surgical repair of entropion can be done safely, resulting in low recurrence rates.
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A Comparison of Surgical Outcomes of Two Combination Surgeries for Involutional Entropion: Fixing 3 vs 2 Pathologic Components. J Craniofac Surg 2019; 30:2304-2307. [PMID: 31478956 DOI: 10.1097/scs.0000000000005677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The purpose of this study was to compare the surgical outcomes of two combinational surgeries for involutional entropion: Inferior retractor tightening (IRT) + lateral tarsal strip (LTS) + skin muscle excision (SME) vs LTS + SME. The authors reviewed the records of 2 groups which were made up of 80 (85 eyelids) and 58 (63 eyelids) involutional entropion patients with 71.4 and 71.8 years on average respectively. The 2 groups were categorized into Group A and Group B by different surgical techniques. The former underwent IRT + LTS + SME surgery between April 2004 and February 2014, while the latter received LTS + SME surgery between March 2014 and February 2018. The authors evaluated the surgical outcomes of 2 combinational surgeries. In Group A, 84 out of 85 (98.8%) lids were successfully corrected and 1 (1.2%) lower eyelid suffered from recurrence during the follow-up period of 26.5 ± 4.6 months. Two canthal deformity cases occurred in this group. In Group B, 62 out of 63 (98.2%) lids were successfully treated and there was 1 (1.8%) case of recurrence during the follow-up period of 21.0 ± 10.0 months. No cases of complications were noted. IRT + LTS + SME procedure took 26.4 ± 2.4 minutes and LTS + SME procedure took 20.6 ± 3.9 minutes (P < 0.001). The LTS + SME technique exhibited a comparable success rate with the IRT + LTS + SME operation. LTS + SME appeared to be significantly faster and safer compared to the IRT + LTS + SME procedure.
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Lin P, Kitaguchi Y, Mupas-Uy J, Sabundayo MS, Takahashi Y, Kakizaki H. Involutional lower eyelid entropion: causative factors and therapeutic management. Int Ophthalmol 2018; 39:1895-1907. [DOI: 10.1007/s10792-018-1004-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 08/11/2018] [Indexed: 11/24/2022]
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