J Korean Ophthalmol Soc.  2007 Oct;48(10):1312-1317. 10.3341/jkos.2007.48.10.1312.

Treatment of Distichiasis or Trichiasis combined with Entropion

• Lee JW
• Shin DS
• Lee KW

• KMID: 2210982
• DOI: http://doi.org/10.3341/jkos.2007.48.10.1312

Abstract

PURPOSE: To evaluate the clinical efficacy of a reverse eyelid splitting technique that we performed in cases of trichiasis or distichiasis combined with entropion.
METHODS
The study comprised 43 eyes of 31 patients with trichiasis or distichiasis combined with entropion treated from November 2004 to December 2005. After skin incision, the muscular layer and tarsus were reversely dissected to find abnormal follicles. The abnormal hair follicle was cauterized under the muscular layer, and 2~3 rotating sutures were done with Ethilon 6-0 to fix the tarsus and skin. Success was defined as having the meibomian gland located in front of the junction of skin and mucosa, without an abnormal hair protruding into the eye for at least three months.
RESULTS
Fifteen patients were male and sixteen patients were female. The mean age was 62.1+/-15.2 years. The patients were followed up for an average of 12.4+/-2.0 months after surgery. Surgery was successful in 74.4% (32 of the 43 eyelids) of the cases, and the recurrence rate was 25.6% (11 of the 43 eyelids). No severe complications occurred, such as infection, hemorrhage, wound dehiscence, or granuloma. However, foreign body sensation (1 eye) and eyelid notch (l eye) did occur.
CONCLUSIONS
This reverse eyelid splitting technique produced satisfactory results in both cosmetic and functional aspects. Moreover, it resulted in a low recurrence rate and low complication rate in patients with trichiasis or distichiasis combined with entropion.

Keyword

Distichiasis; Entropion; Reverse eyelid splitting; Trichiasis

MeSH Terms

Ankle
Entropion*
Eyelids
Female
Foreign Bodies
Granuloma
Hair
Hair Follicle
Hemorrhage
Humans
Male
Meibomian Glands
Mucous Membrane
Nylons
Recurrence
Sensation
Skin
Sutures
Trichiasis*
Wounds and Injuries
Nylons

Figure

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  Figure 1. Preoperative view. The lower eyelid was inverted and cilia touched the cornea.

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  Figure 2. With the lower lid skin being pulled down, incision lines were designed.

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  Figure 3. After excision of excessive skin and muscle layer, remaining muscle layer and tarsal plate were dissected.

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  Figure 4. Cauterization was done at the point of abnormal hair follicles.

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  Figure 5. After rotating suture with Ethilon 6-0, meibomian glands were repositioned to normal posiotion.

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  Figure 6. Skin suture was done by a Black silk 6-0. The eyelid was everted, and no cilia touched the cornea.

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  Figure 7. Postoperative 7th-day view. Meibomian glands were repositioned to normal position and no cilia touched the cornea.

Reference

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