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Woźniak-Roszkowska E, Iljin A, Noszczyk B, Antoszewski B. Evaluation of outcomes of lower eyelid entropion and ectropion surgical repair. POLISH JOURNAL OF SURGERY 2023; 96:50-58. [PMID: 38629275 DOI: 10.5604/01.3001.0053.9352] [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] [Indexed: 04/19/2024]
Abstract
<b><br>Introduction:</b> The imbalance of external and internal forces acting on the lower eyelid can result in entropion and ectropion, both of which cause ocular irritation and loss of proper eye protection. Potential complications of untreated cases include recurrent inflammation of the conjunctiva and cornea, conjunctival neovascularization, corneal abrasion or perforation, and ultimately even loss of vision. Although various surgical techniques are used to address this problem, their long-term outcome and effectiveness are still under discussion. </br> <b><br>Aim:</b> To evaluate outcomes of surgery for entropion and ectropion, including a modified Wheeler's method for entropion correction.</br> <b><br>Methods:</b> A non-comparative study (prospective and retrospective groups) included 100 patients operated on in two university hospitals' plastic surgery departments for lower eyelid entropion or ectropion, following formal ethics approval. The prospective group included 50 patients assessed preoperatively and at 3 and 12 months postoperatively. The retrospective group was comprised of 50 patients (2012-2018), whose preoperative documentation and clinical examinations were analyzed. The main outcome measures were change between pre- and postoperative patient-reported symptoms (VAS scale), ectropion/entropion grading scale (EGS/EnGS), quality of life (WHOQOL-BREF), and occurrence of complications.</br> <b><br>Results:</b> The differences in the severity of all symptoms before and after surgery evaluated with the VAS scale were statistically significant in both groups (p <0.05). We observed 6 recurrences (12%) in the prospective group and 9 (18%) in the retrospective group, with minor complications. Very good functional and esthetic postoperative results were confirmed in 70% (79) of the whole group and in 13 patients (81.3%) treated with the modified Wheeler's method. In the prospective group, the Mann- Whitney U test for dependent variables revealed significant improvement in the somatic, psychological, and environmental domains, with no significant change in the social relationships domain.</br> <b><br>Conclusions:</b> The results following entropion/ectropion surgery prove the effectiveness of the methods used. Complementing them with the modified Wheeler's method brought an increase in the number of very good outcomes. Surgery of lower eyelid malposition contributed to reduced symptoms and improved quality of life. The rates of postoperative sequelae were low.</br>.
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Affiliation(s)
- Ewa Woźniak-Roszkowska
- Department of Plastic, Reconstructive and Aesthetic Surgery, Second Chair of Surgery, Medical University of Lodz, Poland, Department of Plastic Surgery, Prof. W. Orłowski Memorial Hospital, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Aleksandra Iljin
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Lodz, Lodz, Poland
| | - Bartlomiej Noszczyk
- Department of Plastic Surgery, Prof. W. Orłowski Memorial Hospital, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Bogusław Antoszewski
- Department of Plastic, Reconstructive and Aesthetic Surgery, Second Chair of Surgery, Medical University of Lodz, Poland
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Yvon C, Patel B, Malhotra R. Conjunctivochalasis. Int Ophthalmol Clin 2023; 63:209-223. [PMID: 37439619 DOI: 10.1097/iio.0000000000000474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
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Yang Y, Chihaia M, Schulz CB, Kenchington A, Parkin B, MacLean H. 8-0 polyglactin 910 suture in entropion repair: long term follow up and rates of recurrence. Eye (Lond) 2023; 37:618-623. [PMID: 35249106 PMCID: PMC9998438 DOI: 10.1038/s41433-022-01997-5] [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: 10/13/2021] [Revised: 01/31/2022] [Accepted: 02/16/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES The choice of suture is an important consideration in entropion repair, with implications on wound strength, inflammation and scar formation. There is no consensus on the best suture material or gauge of suture at present. We aim to assess the long-term outcome of entropion repair using 8-0 polyglactin sutures, with specific focus on rates of recurrence, wound dehiscence, infection and scarring. METHODS This retrospective case series included consecutive patients from two institutions (84 eyes) undergoing entropion repair using a subciliary incision and a lateral wedge resection. Patients were invited for follow up review and patient records were evaluated to assess for cosmetic and functional outcome, complications and patient satisfaction. RESULTS The median follow-up time from surgery was 48 months (range 20-100). There were five cases of entropion recurrence (5.9%), taking place between 8 months to 4 years after surgery, two cases required further surgery, while three were conservatively treated. There was no wound dehiscence. Two cases (2.4%) of mild superficial wound infections occurred which were successfully treated with topical antibiotics, 1 case (1.2%) of mild lid notching, and 1 case (1.2%) of scarring were recorded. 97% of patients reported to be satisfied with the outcome of their surgery. CONCLUSIONS The use of 8-0 polyglactin suture in entropion repair has resulted in good aesthetic and functional outcome in this case series, with low rates of recurrence, complications, and no case of wound dehiscence, suggesting this suture provides sufficient tensile strength to enable wound closure and healing.
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Affiliation(s)
- Yingjia Yang
- Portsmouth Hospitals University NHS Trust, Portsmouth, PO6 3LY, UK.
| | - Madalina Chihaia
- University Hospitals Dorset NHS Foundation Trust, Bournemouth, BH7 7DW, UK
| | | | | | - Ben Parkin
- University Hospitals Dorset NHS Foundation Trust, Bournemouth, BH7 7DW, UK
| | - Hunter MacLean
- Portsmouth Hospitals University NHS Trust, Portsmouth, PO6 3LY, UK
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Eldesouky MA, Abouelatta MM, Shabana RR, Elbedewy HA. A novel surgical correction technique of involutional entropion by combined triangular tarsectomy, orbicularis muscle tightening and inferior retractor plication. Eur J Ophthalmol 2023:11206721231159693. [PMID: 36843534 DOI: 10.1177/11206721231159693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
PURPOSE Describing a novel collective technique for treatment of involutional entropion of the lower eyelids in patients aged 55 years old or more. METHODS A prospective comparative study included 56 patients (69 eyelids), recruited from the outpatient clinic of Tanta University Eye Hospital, presented with involutional lower eyelid entropion either primary or secondary. They were divided into: 1- Group A 42 eyelids with excessive horizontal lid laxity (pinch test > 8.0 mm), who underwent Combined tarsectomy of a triangle with base down and horizontal tightening of orbicularis muscle. 2- Group B: 27 eyelids with excessive horizontal lid laxity (pinch test < 8.0 mm) who underwent vertical tightening of orbicularis muscle. Follow up of the patients up to 12 month and satisfaction recording were done. RESULTS The mean age of Group A was 60.08 ± 8.38 and of Group B was 55.10 ± 7.40. An overall high success rate (91.07%) and a low recurrence rate (8.92%) with a high post-operative satisfaction, both functionally and cosmetically (96.42%), were reported. CONCLUSION Combined procedures with addressing the horizontal tightening was associated with a higher success rate and a lower recurrence rate.
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Affiliation(s)
- Mohammed A Eldesouky
- Department of Ophthalmology, Faculty of Medicine, 68781Tanta University, Tanta, Egypt
| | - Mahmoud M Abouelatta
- Department of Ophthalmology, Faculty of Medicine, 68781Tanta University, Tanta, Egypt.,Division of Oculofacial Plastic and Reconstructive Surgery, Department of Ophthalmology, Shiley Eye Institute, University of California, San Diego, La Jolla, California, USA
| | - Reham R Shabana
- Department of Ophthalmology, Faculty of Medicine, 68781Tanta University, Tanta, Egypt
| | - Hazem A Elbedewy
- Department of Ophthalmology, Faculty of Medicine, 68781Tanta University, Tanta, Egypt
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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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Schulz CB, Fallico M, Rothwell A, Siah WF. Lower eyelid involutional entropion following cataract surgery. Eye (Lond) 2022; 36:175-181. [PMID: 33664509 PMCID: PMC8727584 DOI: 10.1038/s41433-021-01466-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/19/2021] [Accepted: 02/09/2021] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To determine whether cataract surgery is associated with an increased risk of subsequent lower eyelid entropion and evaluate potential associated factors. METHODS This retrospective cohort study included consecutive patients undergoing first eye cataract surgery over a 10-year period at a single institution (n = 14,574). The fellow phakic eye served as control. Patient records were evaluated up until either the time of second eye cataract surgery or any other intraocular or adnexal surgery. The primary outcome was the rate of entropion repair in both the pseudophakic (exposed) group and the phakic control group. Groups were compared using relative risk and Kaplan-Meier analysis. Multivariate logistic regression was used to compare pre-specified characteristics of those patients that underwent entropion repair in their pseudophakic eye with those that did not. RESULTS A fourfold higher relative risk of undergoing entropion repair was observed in eyes that had undergone cataract surgery compared with the fellow unoperated eye (95% confidence interval 1.6-9.8; P < 0.001) with an increased risk at all timepoints between 1 and 12 years according to Kaplan-Meier analysis (P = 0.001). Median time to entropion repair after cataract surgery was 58 months (range 3-124). Documented intraoperative patient factors such as patient or eye movement, eyelid squeezing, pain or anxiety were an independent risk factor for subsequent entropion (P < 0.0001). CONCLUSIONS Cataract surgery is associated with an increased risk of subsequent lower eyelid entropion. Surgeons should be aware of this risk in the pre- and post-operative assessment of patients undergoing cataract surgery.
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Affiliation(s)
- Christopher B. Schulz
- grid.123047.30000000103590315Eye Unit, University Hospital Southampton, Southampton, UK ,grid.415470.30000 0004 0392 0072Eye Unit, Queen Alexandra Hospital, Portsmouth, UK
| | - Matteo Fallico
- grid.123047.30000000103590315Eye Unit, University Hospital Southampton, Southampton, UK ,grid.8158.40000 0004 1757 1969Department of Ophthalmology, University of Catania, Catania, Italy
| | - Alice Rothwell
- grid.123047.30000000103590315Eye Unit, University Hospital Southampton, Southampton, UK
| | - We Fong Siah
- grid.123047.30000000103590315Eye Unit, University Hospital Southampton, Southampton, UK ,grid.411596.e0000 0004 0488 8430Eye Unit, Mater Misericordiae University Hospital, Dublin 7, Ireland
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Cai J, Zhou Y, Lv W, Chen W, Cai W, Ng TK, Li Z. Pretarsal orbicularis oculi muscle tightening with skin flap excision in the treatment of lower eyelid involutional entropion. BMC Ophthalmol 2021; 21:435. [PMID: 34911482 PMCID: PMC8675534 DOI: 10.1186/s12886-021-02214-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 12/10/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND To evaluate a modified technique for involutional entropion correction in a retrospective cohort study. METHODS The patients with involutional entropion eyelid were corrected by tightening the pretarsal orbicularis oculi muscle and excising the excess skin of the lower eyelid. The patients received correction surgery from April 2013 to March 2019 were followed up for more than 6 months postoperatively. The outcome measures included the complications and the recurrence rates. RESULTS Total 152 patients (169 eyes) were included. The mean follow-up period was 29.6 months (range: 6-36 months). Postoperative ectropion (over-correction) was observed in 1 patient with 1 eyelid (0.59%); yet, no further surgery was needed for this patient. Recurrence of entropion was found in 1 patient (0.59%). The patient with recurrent entropion received repeated surgery with the same method and achieved a good eyelid position. CONCLUSIONS This study demonstrated that tightening the pretarsal orbicularis oculi muscle and excising the excess skin of the lower eyelid could be an effective surgical method to correct lower eyelid involutional entropion. This method is technically easy with a low recurrence rate and not associated with significant complications in Asians.
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Affiliation(s)
- Jianhao Cai
- Joint Shantou International Eye Centre of Shantou University and The Chinese University of Hong Kong, North Dongxia Road, Shantou, 515041, Guangdong, China
| | - Yuansheng Zhou
- Joint Shantou International Eye Centre of Shantou University and The Chinese University of Hong Kong, North Dongxia Road, Shantou, 515041, Guangdong, China
| | - Wenjuan Lv
- Joint Shantou International Eye Centre of Shantou University and The Chinese University of Hong Kong, North Dongxia Road, Shantou, 515041, Guangdong, China
| | - Wenxia Chen
- Joint Shantou International Eye Centre of Shantou University and The Chinese University of Hong Kong, North Dongxia Road, Shantou, 515041, Guangdong, China
| | - Weihao Cai
- Joint Shantou International Eye Centre of Shantou University and The Chinese University of Hong Kong, North Dongxia Road, Shantou, 515041, Guangdong, China
| | - Tsz Kin Ng
- Joint Shantou International Eye Centre of Shantou University and The Chinese University of Hong Kong, North Dongxia Road, Shantou, 515041, Guangdong, China
- Shantou University Medical College, Shantou, 515041, Guangdong, China
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
| | - Zeyi Li
- Joint Shantou International Eye Centre of Shantou University and The Chinese University of Hong Kong, North Dongxia Road, Shantou, 515041, Guangdong, China.
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Affiliation(s)
- Farida Hakim
- Department of Ophthalmology and Visual Science, University of Chicago, Chicago, IL, United States
| | - Paul O Phelps
- Department of Ophthalmology and Visual Science, University of Chicago, Chicago, IL, United States; Division of Ophthalmology, Northshore University HealthSystem, 2050 Pfingsten Rd., Ste. 280, Glenview, IL 60026, United States.
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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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Nakos EA, Boboridis KG, Kakavouti-Doudou AA, Almaliotis DD, Sioulis CE, Karampatakis VE. Randomized Controlled Trial Comparing Everting Sutures with a Lateral Tarsal Strip for Involutional Lower Eyelid Entropion. Ophthalmol Ther 2019; 8:397-406. [PMID: 31127533 PMCID: PMC6692799 DOI: 10.1007/s40123-019-0189-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION To compare the anatomical and functional outcome and changes in the quality of life (QoL) over time of the lateral tarsal strip (LTS) versus the Quickert everting sutures (ES) for the repair of primary involutional lower eyelid entropion. METHODS Forty-five patients (54 eyes) with primary involutional lower eyelid entropion were recruited in a prospective randomized clinical trial over 3-year period. Twenty-six eyes were randomized to the LTS technique and 28 to the ES procedure. Primary outcome was the anatomical correction of the eyelid at the final assessment in 1 year. Secondary outcomes were function and symptoms assessment with a QoL questionnaire at 6 months. Fisher's exact test was used for the statistical analysis of success rate and gender study and Mann-Whitney U test and logistic regression analysis were used for age study. The Wilcoxon and Mann-Whitney U tests were used for the analysis of the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25). RESULTS At the 6-month follow-up, 25 eyes (96.2%) of the LTS group and 20 (71.4%) of the ES group had favorable outcome (P = 0.025). There were one and eight eyes, respectively, with early recurrence. At the final 12-month evaluation, 23 eyes (88.5%) in the LTS group and 16 eyes (57.1%) in the ES group were successful. Three (11.5%) and 12 (42.9%) eyes respectively showed postoperative recurrence. There was a statistically significant difference between the two groups (P = 0.015) for the primary outcome, whereas age and gender did not influence success. The NEI VFQ-25 showed statistically significant subjective improvement from baseline in most categories of the QoL. No significant difference between the two procedures was detected at 6 months. CONCLUSION This study suggests that the LTS procedure has a superior surgical success rate and reduction of symptoms compared with the ES for the repair of involutional lower eyelid entropion. Both procedures showed similar improvement of the postoperative QoL. TRIAL REGISTRATION International Clinical Trials Registry Platform identifier: ACTRN12616000620426.
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Affiliation(s)
- Elias A Nakos
- 424 Army General Training Hospital, Thessaloniki, Greece.
| | | | | | - Diamantis D Almaliotis
- Lab of Experimental Ophthalmology, Aristotle University Medical School, Thessaloniki, Greece
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Han J, Lee SH, Shin HJ. Mini-incisional entropion repair for correcting involutional entropion: Full description and surgical outcome. Medicine (Baltimore) 2019; 98:e16731. [PMID: 31415368 PMCID: PMC6831266 DOI: 10.1097/md.0000000000016731] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The aim of the study was to report the surgical outcome of mini-incisional correction method to treat involutional entropion.This is a retrospective interventional case series of 46 eyelids in 31 patients with involutional entropion and significant ocular irritation. In this technique, after turning the lower eyelid inside out, threads are introduced into it through the conjunctiva close to the inferior fornix. The lower lid retractor and tarsus are then connected using threads. These threads are applied at 3 locations of the lower eyelid and tightening them results in the eyelid being everted and the correction of entropion. Surgical success was defined as no contact between the eyelashes and the globe during forced closure of the eyelids. Surgical failure was defined as persistence of the eyelashes remaining in contact with the globe or cosmetic dissatisfaction.During the mean follow-up period of 22.1 months (range, 12-34 months), 43 of the eyelids (93.5%) were successfully corrected. Two patients (3 eyelids) experienced recurrence: 1 had involutional entropion combined with a cicatricial component, and the other had blepharospasm and apraxia of eyelid opening related to Parkinsonism. No postoperative complications such as overcorrection, suture-knot exposure, or ocular irritation were observed.Our mini-incisional entropion repair is based on reinforcement of the lower eyelid retractors using transconjunctival buried sutures. This technique is a quick, simple, and predictive for involutional entropion repair, and has a high success rate.
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Affiliation(s)
- Jisang Han
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine
| | - Shin-Hyo Lee
- Department of Anatomy, Research Institute of Medical Science, Konkuk University School of Medicine
| | - Hyun Jin Shin
- Department of Ophthalmology, Research Institute of Medical Science, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
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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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Association of Involutional Lower Eyelid Entropion with Reduced Upper Eyelid Position Relative to the Corneal Light Reflex: Quantification of Facial Asymmetry. Ophthalmic Plast Reconstr Surg 2018; 34:467-471. [PMID: 29342029 DOI: 10.1097/iop.0000000000001059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate the association between upper eyelid position relative to the corneal light reflex (MRD1) and to delineate an association between eyelid height and involutional lower eyelid entropion. METHODS Retrospective study of patients presenting for entropion repair to an academic ophthalmic plastic surgery service. A total of 111 patients were included in the study; 95 had unilateral involutional lower eyelid entropion, and 16 had bilateral lower eyelid entropion. Patients with a history of previous eyelid surgery, trauma, upper eyelid entropion, or cicatricial changes were excluded from the study. RESULTS Of the 95 patients with unilateral involutional lower eyelid entropion, 45 (47.4%) had a lesser MRD1 on the side ipsilateral to the involutional lower eyelid entropion. In this unilateral group, the mean MRD1 (± standard deviation) on the ipsilateral to the involutional lower eyelid entropion was 2.9 (±1.2) mm, while the mean MRD1 on the contralateral side was 3.3 (±1.0) mm. This difference was 0.4 mm and was statistically significant (p < 0.0001). Most patients with unilateral involutional entropion demonstrated a right-sided involutional lower eyelid entropion (56 of 95; 58.9%), although this finding was not statistically significant (p = 0.083). The frequency of true blepharoptosis (MRD1 ≤ 2.0 mm) was 24 of 95 (25.3%) in the unilateral involutional entropion group and was even higher in the bilateral involutional lower eyelid entropion group, with 7 of 16 (43.8%) patients exhibiting bilateral blepharoptosis. CONCLUSIONS Patients presenting with involutional lower eyelid entropion tend to have a relatively reduced MRD1 on the ipsilateral (affected) side. When both lower eyelids are affected by involutional entropion, the reduced MRD1 tends to be more pronounced.
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Huh J, Park J, Baek S. Changes in the Horizontal Angular Direction of Lower Eyelashes with Age in Korean Patients. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.2.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jungah Huh
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Jinhwan Park
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Sehyun Baek
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
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Mcveigh KA, Harrison R, Ford R. Entropion and ectropion repair: a snapshot of surgical practice in the United Kingdom. Orbit 2017; 37:105-109. [PMID: 29053043 DOI: 10.1080/01676830.2017.1383461] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We aim to provide a snapshot of the current surgical practice for correction of entropion and ectropion, the two most common oculoplastic procedures carried out in the UK, by surveying 135 consultant oculoplastic surgeons via the tool Survey Monkey. Forty-seven (35%) consultants responded. For entropion, 44% of surgeons opted for lateral tarsal strip (LTS) + everting sutures (ES). Other first-line choices included LTS + transcutaneous retractor plication (21%), Quickert's procedure (14%), ES (7%), and Wies procedure (5%). Important patient-related factors to consider were horizontal lid laxity and retractor dehiscence. Regarding ectropion, LTS was most commonly practiced (35%), followed by LTS + transconjunctival retractor plication (28%), wedge excision (16%), and lateral canthoplasty (5%). The patient-related factors guiding choice were horizontal lid laxity, lateral canthal tendon laxity, and punctal position under traction. Responses found a wide range of preferred surgical techniques in practice. The factors guiding surgical choice were personal audit results (92% stated important/very important), familiarity with the technique (92%), and the technique being favoured by previous trainers (76%), suggesting current practice led by expert opinion, possibly due to a lack of evidence-based literature. This highlights the variety of core oculoplastic surgical techniques practiced and underlines the need for robust trials to guide surgical choice.
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Affiliation(s)
- Katherine Anne Mcveigh
- a Department of Oculoplastic and Orbital Surgery, Bristol Eye Hospital , University Hospitals Bristol NHS Trust , Bristol , UK
| | - Rhys Harrison
- a Department of Oculoplastic and Orbital Surgery, Bristol Eye Hospital , University Hospitals Bristol NHS Trust , Bristol , UK
| | - Rebecca Ford
- a Department of Oculoplastic and Orbital Surgery, Bristol Eye Hospital , University Hospitals Bristol NHS Trust , Bristol , UK
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Nemoto H, Togo T, Maruyama N, Miyabe K, Nakae S, Sumiya N. Orbicularis oculi muscle tightening for involutional entropion. J Plast Reconstr Aesthet Surg 2017; 70:946-951. [DOI: 10.1016/j.bjps.2017.01.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 01/20/2017] [Accepted: 01/31/2017] [Indexed: 11/15/2022]
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Ko AC, Korn BS, Kikkawa DO. The aging face. Surv Ophthalmol 2017; 62:190-202. [DOI: 10.1016/j.survophthal.2016.09.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 09/10/2016] [Accepted: 09/16/2016] [Indexed: 11/17/2022]
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Success rate of nurse-led everting sutures for involutional lower lid entropion. Eye (Lond) 2017; 31:732-735. [PMID: 28085138 DOI: 10.1038/eye.2016.314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 11/27/2016] [Indexed: 11/08/2022] Open
Abstract
PurposeTo evaluate safety and long-term recurrence rate of entropion in patients having everting sutures (ES) for involutional entropion by ophthalmic nurses in a real clinical setting.Patients and methodsRetrospective notes review of all patients who had an outpatient ES by our trained ophthalmic nurses over 2 year's time period. Outcome measures were complication and recurrence rates. Those with less than 3 years' recorded follow-up were contacted by paper questionnaire.Results90 lids of 82 patients analysed. Mean age was 78 (range 54-97). In total, 82% had no entropion surgery before, whereas 13% had previous ES and 5% one or more other procedures. Questionnaires were sent to 38, with return rate of 81%. Recurrence rate was 21.1% after 36-60 months follow up from nurse-performed ES, with mean time to recurrence of 15 months (SD 13 months). A total of 32% of patients died during the follow-up period. Mean time between the procedure and death is 20.5 months. When ES were repeated twice (11 patients), recurrence rate was still 20%. No patients had any complications.ConclusionES can be safely performed by ophthalmic nurses, with success rate comparable to the same technique performed by ophthalmologists.
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Kim TH, Lee K. Long-term Results of Interrupted Buried Suture Method Using Non-absorbable Material for Involutional Lower Lid Entropion. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2016. [DOI: 10.3341/jkos.2016.57.12.1827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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