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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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Al-Mujaini AS, Ul Kadir SM, Maurya RP. Outcomes of combined procedures compared to various single techniques for involutional entropion. Oman J Ophthalmol 2023; 16:439-445. [PMID: 38059104 PMCID: PMC10697267 DOI: 10.4103/ojo.ojo_43_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/19/2023] [Accepted: 08/13/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND To describe the outcomes of triangular tarsectomy and limited orbicularis myectomy with lower eyelid retractor plication compared to an everting sutures (ES) technique or lateral tarsal strip (LTS) procedure for the correction of lower eyelid involutional entropion. METHODS A nonrandomized clinical study was carried out at two tertiary eye hospitals between January 2016 and December 2019. Patients in Group A underwent triangular tarsectomy and limited orbicularis myectomy with lower eyelid retractor plication. Group B had ES, and Group C underwent a LTS procedure. All participants were operated by one surgeon and underwent 1-year follow-up. RESULTS A total of 78 patients in whom 84 eyelids were affected by lower eyelid involutional entropion were included in the study. The success rate was higher in Group A compared to Group B and Group C (100% vs. 86.7% vs. 95.8%; P < 0.05). Recurrence at a 1-year follow-up was noted in only four (13.3%) eyelids in Group B and one (4.2%) in Group C. However, patient's in Group C experienced a higher frequency of minimal postoperative complications, including short-term pain (100%), tenderness on the lateral canthal area (100%), tightness of the eyelid (91.7%), and ecchymosis (54.2%) compared to Group A. Patients of Group B experienced minimal or no postoperative complications. CONCLUSIONS Triangular tarsectomy and limited orbicularis myectomy with eyelid retractor plication may be considered the standard procedure for correcting lower eyelid involutional entropion with no recurrence compared to LTS technique or minimally invasive and cost-effective ES procedure.
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Affiliation(s)
- Abdullah S. Al-Mujaini
- Department of Ophthalmology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Syeed Mehbub Ul Kadir
- Department of Ophthalmology, Sheikh Fazilatunnesa Mujib Eye Hospital and Training Institute, Gopalgonj, Bangladesh
| | - Rajendra Prakash Maurya
- Department of Ophthalmology, Regional Institute of Ophthalmology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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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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Mateos-Olivares M, Belani-Raju M, Sánchez-Tocino H, Ye-Zhu C, Sales-Sanz M, Bragante A, Fernandes de Sousa Meneghim RL, Schellini SA, Galindo Ferreiro A. Anterior versus posterior retractor reinsertion with a lateral tarsal strip for involutional entropion repair: A multicentric experience. Eur J Ophthalmol 2023:11206721231155665. [PMID: 36760116 DOI: 10.1177/11206721231155665] [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: 02/11/2023]
Abstract
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.
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Affiliation(s)
- Milagros Mateos-Olivares
- Ophthalmology Department, 16238Hospital Clínico Universitario de Valladolid (HCUV), Valladolid, Spain
| | - Minal Belani-Raju
- Ophthalmology Department, 16918Hospital Universitario Río Hortega, Valladolid, Spain
| | | | - Cristina Ye-Zhu
- Ophthalmology Department, 16507Hospital Universitario Ramon y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Marco Sales-Sanz
- Ophthalmology Department, 16507Hospital Universitario Ramon y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.,IMO Grupo Miranza, Madrid, Spain
| | - André Bragante
- Ophthalmology Department of Medical School, 67785State University of Sao Paulo (UNESP), São Paulo, Brazil
| | | | - Silvana A Schellini
- Ophthalmology Department of Medical School, 67785State University of Sao Paulo (UNESP), São Paulo, Brazil
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Kopecký A, Rokohl AC, Heindl LM. The role of the lateral tarsal strip procedure in modern ophthalmic plastic surgery-A review. FRONTIERS IN OPHTHALMOLOGY 2022; 2:871964. [PMID: 38983505 PMCID: PMC11182132 DOI: 10.3389/fopht.2022.871964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/27/2022] [Indexed: 07/11/2024]
Abstract
Introduction The lateral tarsal strip is one of the basic surgical techniques in ophthalmic plastic surgery. It is used in many indications, predominantly in ectropion repair. Even though there are alternatives, it is probably one of the most popular techniques in ophthalmic plastic surgery. The lateral tarsal strip is also part of bigger surgical procedures (such as midface lifting, entropion surgery, reconstruction surgery, or a part of some surgical approaches to the orbit). The aim of this review is to assess the most common ways of usage of the lateral tarsal strip, to cover its alternatives, and to discuss the future of this technique. Methods We have search PubMed and Web of Science and went through articles about lateral tarsal strip. We have also searched for other techniques that used the lateral tarsal strip and included these articles in our review. We have analyzed the major articles and made a review about the topic. Results As a natural part of many advanced surgical techniques and as a major surgical technique for lower eyelid ectropion repair, the lateral tarsal strip remains an important part of modern ophthalmic plastic surgery.
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Affiliation(s)
- Adam Kopecký
- Ophthalmology Clinic, University Hospital Ostrava, Ostrava, Czechia
- Faculty of Medicine and University Hospital Cologne, Department of Ophthalmology, University of Cologne, Cologne, Germany
- Faculty of Medicine, Department of Craniofacial Surgery, University of Ostrava, Ostrava, Czechia
| | - Alexander C Rokohl
- Faculty of Medicine and University Hospital Cologne, Department of Ophthalmology, University of Cologne, Cologne, Germany
| | - Ludwig M Heindl
- Faculty of Medicine and University Hospital Cologne, Department of Ophthalmology, University of Cologne, Cologne, Germany
- Center for Integrated Oncology (CIO) Aachen - Bonn - Cologne - Duesseldorf, Cologne, Germany
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Serbest Ceylanoglu K, Malkoc Sen E, Corak Eroglu F, Yenigun S. Comparison of the two techniques for involutional lower eyelid entropion: A retrospective study. J Craniomaxillofac Surg 2021; 49:1005-1009. [PMID: 34176714 DOI: 10.1016/j.jcms.2021.06.010] [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: 01/06/2021] [Revised: 05/26/2021] [Accepted: 06/15/2021] [Indexed: 11/28/2022] Open
Abstract
Evaluation of the surgical outcome and the patient satisfaction between the modified Wies technique and the Jones retractor plication technique for involutional lower eyelid entropion without horizontal eyelid laxity. Patients who underwent the modified Wies technique (group 1) and the Jones retractor plication technique (group 2) for correction of involutional lower eyelid entropion without horizontal eyelid laxity between January 2014 and January 2020 were retrospectively reviewed. Patients with horizontal eyelid laxity; cicatricial, congenital or iatrogenic entropion; and less than 6 months of follow-up time were excluded. The main outcome measures were the recurrence rate, correct anatomical position of the eyelid, symptom relief, and postoperative complications for both groups. 37 patients (41 eyes) in Group 1 and 34 patients (34 eyes) in Group 2 were enrolled in the study. Mean age ± SD was 75.6 ± 8.5 years in Group 1 and 73.4 ± 7.9 years in Group 2 (p:0.255). The mean follow-up time (range) was 24.3 (6-80) months in group 1 and 25.3 (6-78) months in group 2 (p:0.818). Two patients in Group 1 and seven patients in Group 2 had a recurrence during the follow-up period (p:0.07). Based on the results of the study, it seems that the modified Wies technique may be a good alternative in suitable patients, as it has satisfactory surgical results.
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Affiliation(s)
- Kubra Serbest Ceylanoglu
- University of Health Sciences, Ulucanlar Eye Education and Research Hospital, 06250, Altındağ, Ankara, Turkey.
| | - Emine Malkoc Sen
- University of Health Sciences, Ulucanlar Eye Education and Research Hospital, 06250, Altındağ, Ankara, Turkey.
| | - Fatma Corak Eroglu
- University of Health Sciences, Ulucanlar Eye Education and Research Hospital, 06250, Altındağ, Ankara, Turkey.
| | - Sule Yenigun
- University of Health Sciences, Ulucanlar Eye Education and Research Hospital, 06250, Altındağ, Ankara, Turkey.
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Kiel M, Butsch C, Ponto KA, Pfeiffer N, Elflein HM. Patientenzufriedenheit nach lateraler Zügelplastik mit Schöpfer-Naht zur Korrektur des involutiven Entropiums – eine postoperative Auswertung. SPEKTRUM DER AUGENHEILKUNDE 2021. [DOI: 10.1007/s00717-021-00485-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Vydláková J, Tesař J, Krátký V, Šín M, Němec P. LATERAL TARSAL STRIP TECHNIQUE IN CORRECTION OF EYELID ECTROPION AND ENTROPION. CESKA A SLOVENSKA OFTALMOLOGIE : CASOPIS CESKE OFTALMOLOGICKE SPOLECNOSTI A SLOVENSKE OFTALMOLOGICKE SPOLECNOSTI 2021; 77:73-78. [PMID: 33985336 DOI: 10.31348/2021/10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Ectropion and entropion are eyelid malpositions associated with a number of unpleasant symptoms. One of several surgical methods that can correct these problems is referred to as the lateral tarsal strip technique. In this paper, we evaluate the postoperative results and quality of this technique. We also examine the complications associated with this surgical method. METHODS The study took place from April 2018 to April 2020 at the Military University Hospital in Prague. The operation was performed by two surgeons. The study included 43 eyes of 33 patients (17 women and 16 men), average age was 79 years. Before the operation, 23 eyes were affected by ectropion and 20 eyes affected by entropion, 35 of the 43 were cases of involutional origin. The study does not include patients who underwent other surgical techniques. RESULTS There were no perioperative or postoperative complications in the entropion surgery group. Successful correction was achieved, and adverse symptoms disappeared in 91.3% of cases. Correct position of the eyelid was not achieved in two cases. For patients with ectropion, surgical correction was successful in 95% of cases. Ectropion persisted after surgery only in one patient. CONCLUSION The lateral tarsal strip technique is a safe, reliable and highly effective surgical technique. Correction of eyelid malposition was achieved in more than 90% of cases. The vast majority of patients were satisfied and reported relief from preoperative symptoms.
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A 2-step Procedure for Entropion Treatment: Eyelid Splitting and Full-thickness Everting Sutures. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e3176. [PMID: 33425571 PMCID: PMC7787272 DOI: 10.1097/gox.0000000000003176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 08/18/2020] [Indexed: 11/26/2022]
Abstract
Background: This study aimed to evaluate the clinical efficacy of the 2-step procedure used for treating entropion patients: (1) performing a grey line split incision and recessing the anterior lamella; (2) using full-thickness everting sutures of the eyelid to enhance the rotating effect. Methods: In total, 31 eyelids of 21 patients were reviewed (male–female ratio = 11:10), with each patient having either upper or lower, or both eyelid entropion due to various causes. All patients underwent the two-step procedure by eyelid splitting and full-thickness everting sutures at the Bundang Cha Hospital from August 2014 until July 2018. Results: The mean follow-up duration was 24.3 months (range, 14–107 months). The causes of entropion included involutional entropion (15 eyelids), congenital entropion (10 eyelids), and cicatrical entropion (6 eyelids). Surgery was re-performed on 16 eyelids due to recurrences from previous electrolysis or surgical correction of entropion such as capsulopalpebral fascia repair, full-thickness rotating suture, or folliculectomy. The two-step procedure was performed on all 31 eyelids, and 9 eyelids received additional excision of skin. After the 2-step procedure, patients showed improvement in symptoms, and all were satisfied with the contour of their eyelids. During the follow-up period, there were no recurrences or complications. Conclusion: A two-step procedure involving eyelid splitting and full-thickness everting sutures is an effective surgical method to treat entropion due to various causes, when compared with other conventional methods.
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Modified everting sutures combined with reattachment to the inferior tarsal plate for involutional lower eyelid entropion: A new technique. Arch Plast Surg 2020; 47:347-353. [PMID: 32718114 PMCID: PMC7398807 DOI: 10.5999/aps.2020.00220] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 06/18/2020] [Indexed: 11/12/2022] Open
Abstract
Background This study evaluated the outcomes of a new modified Wies technique for patients with involutional lower eyelid entropion without horizontal eyelid laxity. Methods This case series retrospectively analyzed consecutive patients with entropion who underwent surgery between January 2014 and March 2019 by the same experienced surgeon. Horizontal eyelid laxity, lower eyelid retractor function, and orbicularis muscle overriding were recorded before and after surgery. The recurrence rate and complications were also evaluated. This technique consisted of modified everting sutures combined with reattachment of the lower eyelid retractors to the inferior tarsal plate. Results This new technique was performed on 28 eyes in 25 patients (mean age, 71.0±8.0 years; range, 56–87 years). Nine patients (36%) were women and 16 (64%) were men. Lower lid entropion was present in the right eye in 14 patients (56%), the left eye in eight patients (32%), and both eyes in three patients (12%). The mean follow-up period was 27.3±12.4 months (range, 6–60 months). No intraoperative complications were observed. All patients’ symptoms were alleviated. One patient (3.6%) had recurrence after 2 years (success rate, 96.4%). The remaining 27 eyes maintained a satisfactory and comfortable eyelid position. No patients had problems with scarring. Conclusions The approach described herein proved to be safe and feasible in eyes with involutional lower eyelid entropion without horizontal eyelid laxity. These advantages of this procedure include the lack of a conjunctival scar, punctal eversion, and lateral canthal angle deformation. A low recurrence rate and a long interval to recurrence were also observed.
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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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Dulz S, Green S, Mehlan J, Schüttauf F, Keserü M. A comparison of the lateral tarsal strip with everting sutures and the Quickert procedure for involutional entropion. Acta Ophthalmol 2019; 97:e933-e936. [PMID: 30916886 DOI: 10.1111/aos.14093] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Accepted: 03/03/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIMS To provide evidence of statistically significant difference in the surgical outcome of the lateral tarsal strip with everting sutures (LTS + ES) versus the Quickert procedure (QP) in the treatment of involutional entropion. METHODS In a prospective randomized comparative trial, 66 eyelids of 52 patients with primary involutional lower eyelid entropion were recruited. Thirty-six eyelids were randomized to QP, and 30 eyelids were randomized to LTS + ES. Surgery was performed by a single surgeon. Postoperative follow-up was scheduled after 2 weeks, 8 and 14 months. Successful surgery was defined as a normal eyelid position at rest and inability to induce entropion on forced eyelid closure at or before the 14-month follow-up visit. RESULTS A total of 66 eyelids of 52 patients were enrolled in the study. Three patients did not complete follow-up (1 did not attend the 8 months follow-up visit; 2 did not attend 14 months follow-up visit). Of the 63 patients, a single eyelid [success probability 0.97; confidence interval (CI) 0.92-1] in the QP group and two treated eyelids [success probability of 0.93; CI: 0.85-1] in the LTS + ES group had a recurrence of a lower eyelid entropion after 14 months. There was no statistically significant difference in surgical failure between the LTS + ES versus QP (Log-rank test: p = 0.46). CONCLUSION These data provide strong evidence that success rates at 14 months are similar in patients treated with either techniques (LTS + ES versus QP).
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Affiliation(s)
- Simon Dulz
- Department of Ophthalmology University Hospital Hamburg‐Eppendorf HamburgGermany
| | - Sylvia Green
- Department of Ophthalmology University Hospital Hamburg‐Eppendorf HamburgGermany
| | - Juliane Mehlan
- Department of Ophthalmology University Hospital Hamburg‐Eppendorf HamburgGermany
| | - Frank Schüttauf
- Department of Ophthalmology University Hospital Hamburg‐Eppendorf HamburgGermany
| | - Matthias Keserü
- Department of Ophthalmology Asklepios Clinic Barmbek Hamburg Germany
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Comparison of four Combined Procedures for Correction of Involutional Lower Eyelid Entropion. J Craniofac Surg 2019; 30:1239-1244. [DOI: 10.1097/scs.0000000000005466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Lai A Fat NNJ, Paridaens D, van den Bosch WA. Surgical correction of involutional lower lid entropion with lateral canthal eyelid block excision and imbrication of the capsulopalpebral ligament using non-buried non-resorbable imbricating sutures versus buried resorbable imbricating sutures. Orbit 2019; 38:7-12. [PMID: 29498554 DOI: 10.1080/01676830.2018.1446538] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 02/19/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE To compare the results of surgical correction of involutional lower eyelid entropion using either buried resorbable imbricating sutures or non-buried non-resorbable sutures that were removed after five to seven days. METHODS Retrospective analysis of a two-surgeon series. Analysis of the charts of patients surgically treated for involutional lower eyelid entropion between January 2011 and December 2014 with a minimum follow-up of 12 months. MAIN OUTCOME MEASURES Recurrence rate, postoperative complications. RESULTS We included 281 eyelids of 240 patients. Of these, 89 eyelids had been treated with buried resorbable imbricating sutures (surgeon WvdB) and 192 with non-buried non-resorbable sutures (surgeon DP). Of the 281 eyelids, 77 eyelids had undergone previous entropion surgery. In the buried resorbable suture group (group R), the mean follow-up was 30 months (range 12 to 61 months) versus 39 months (range 14 to 60 months) in the non-buried non-resorbable group (group NR) (p = 0.07). With a follow-up of up to 18 months, the recurrence rate was 2.2% in group R and 4.2% in group NR (p = 0.73). With a similar follow-up, the recurrence rate was 3.9% after primary surgery versus 2.6% in recurrent cases (p = 0.73). Minor postoperative complications and side-effects were seen in 5.3% (15/281). CONCLUSION We found no difference in the recurrence rate between the use of buried resorbable imbricating sutures and non-buried non-resorbable sutures and between primary versus recurrent cases. We conclude that we can safely use buried resorbable imbricating sutures in involutional entropion. It yields comparable results and omits the need for suture removal.
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Affiliation(s)
- Nathalie N J Lai A Fat
- a Department of Oculoplastic and Orbital Surgery , The Rotterdam Eye Hospital , Rotterdam , the Netherlands
| | - Dion Paridaens
- a Department of Oculoplastic and Orbital Surgery , The Rotterdam Eye Hospital , Rotterdam , the Netherlands
| | - Willem A van den Bosch
- a Department of Oculoplastic and Orbital Surgery , The Rotterdam Eye Hospital , Rotterdam , the Netherlands
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Cheung JJC, Wong CKH, Cheung LTY. Combined pentagonal resection and inferior retractor plication in involutional entropion. BMC Ophthalmol 2018; 18:329. [PMID: 30567578 PMCID: PMC6299990 DOI: 10.1186/s12886-018-0986-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 11/29/2018] [Indexed: 12/02/2022] Open
Abstract
Background To describe the effectiveness of combined pentagonal resection and inferior retractor plication (PR + IRP) based on the Hill’s procedure for the treatment of primary involutional lower eyelid entropion in the Chinese population. Methods This is a retrospective review of 52 eyelids of 46 patients who underwent PR + IRP for treatment of involutional entropion between May 2009 and May 2017. Patient demographics, presence of pre-operative laxity, post-operative outcome and presence of complications were all recorded from electronic patient records. Results A total of 52 eyelids of 46 patients received PR + IRP. None had recurrence of entropion, 1 (2.1%) had residual entropion, 2 eyelids (4.4%) had lower eyelid notching, 1 eyelid (2.2%) had infection and 1 eyelid (2.2%) had overcorrection. The overall success rate was 90.4%. Conclusion Combined PR + IRP is an effective surgical procedure for primary involutional entropion with low recurrence rate. However, it may carry risk of eyelid notching post-operatively.
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Affiliation(s)
- Janice J C Cheung
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong, Special Administrative Region of China. .,Department of Ophthalmology, Grantham Hospital, Hong Kong, Hong Kong, Special Administrative Region of China.
| | - Carlos K H Wong
- Department of Family Medicine and Primary Care, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong, Special Administrative Region of China
| | - Leanne T Y Cheung
- LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong, Special Administrative Region of China
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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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Athavale DD, O'donnell BA. Lower eyelid entropion repair with retractor mobilization and insertion onto the anterior surface of the tarsal plate. Orbit 2018; 37:121-124. [PMID: 29040033 DOI: 10.1080/01676830.2017.1383450] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE To evaluate a modified surgical technique for the correction of lower eyelid involutional entropion in terms of recurrence rate and relief of symptoms. METHOD A prospective series of 67 consecutive eyelids in 55 patients who underwent lower eyelid entropion repair using a modified surgical approach not previously published in the literature to the authors' knowledge. The surgical technique, via a skin crease incision, involves disinsertion of the lower eyelid retractors from the tarsus and conjunctiva and suturing the retractors onto the anterior surface of the tarsal plate. Standard excision of redundant lower lid skin and orbicularis muscle was also performed as well as lateral canthal tendon repair. All procedures were performed by a single surgeon (B. A. O'donnell). This study adhered to the principles of the Declaration of Helsinki. RESULTS There were 67 eyelids with a minimum of 12 months follow-up: of these only 1 patient (1%) required revision surgery (average follow-up 24 months). Four other eyelids had persistent or recurrent irritation (6%) not suggestive of, or secondary to, recurrence. Seven eyelids (10%) had undergone previous operative repair with no further recurrence following their most recent surgery. CONCLUSION Disinsertion and reattachment of the retractors to the anterior tarsal plate in lower eyelid entropion repair is an effective surgical technique to improve lower eyelid stability. Although minimum follow-up is 12 months and average follow-up 24 months, longer follow-up would further evaluate this technique.
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Affiliation(s)
| | - Brett A O'donnell
- a Department of Ophthalmology , Royal North Shore Hospital , Sydney , NSW , Australia
- b Department of Ophthalmology , St. Vincent's Hospital , Sydney , NSW , Australia
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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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Lee SC, Kim JH, Lee SU, Kim SC. Lateral tarsoligamentous sling: A successful treatment for involutional entropion in Asians as a modified lateral tarsal strip. J Craniomaxillofac Surg 2017; 45:1687-1691. [DOI: 10.1016/j.jcms.2017.07.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 06/30/2017] [Accepted: 07/24/2017] [Indexed: 11/28/2022] Open
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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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Yang SW, Park JH, Lee JS, Lee H, Baek SH. Effectiveness of Combined Surgery Simultaneously Correcting 3 Main Causes of Involutional Entropion. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2016. [DOI: 10.3341/jkos.2016.57.3.347] [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)
- Sung Won Yang
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Jin Hwan Park
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Jun Sik Lee
- Department of Ophthalmology, Cheonan Chungmu Hospital, Cheonan, Korea
| | - Hwa Lee
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Se Hyun Baek
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
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Lokdarshi G, Pushker N, Bajaj MS, Meel R. Entropion: understanding the management. EXPERT REVIEW OF OPHTHALMOLOGY 2015. [DOI: 10.1586/17469899.2015.1112738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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