J Korean Ophthalmol Soc.  2009 Apr;50(4):497-504. 10.3341/jkos.2009.50.4.497.

The Effect of Augmented Lateral Tarsal Strip for Paralytic Ectropion in Leprosy Patients

• Kim KH
• Chung IY
• Seo SW

• KMID: 2212248
• DOI: http://doi.org/10.3341/jkos.2009.50.4.497

Abstract

PURPOSE: To analyze the effect of the augmented lateral tarsal strip for the correction of the paralytic ectropion in leprosy patients.
METHODS
Ten leprosy patients (16 eyelids) with exposed keratitis and lagophthalmos from paralytic ectropion underwent surgery of the augmented lateral tarsal strip. Preoperative and postoperative vertical palpebral aperture, marginal reflex distance, lagophthalmos, and anterior segment findings were recorded at 3 and 6 months after surgery. Postoperative symptomatic and functional improvements were assessed at 6 months after surgery.
RESULTS
There was a significant reduction between preoperative and postoperative measurements for vertical palpebral aperture (3.1+/-0.4 mm), lower marginal reflex distance (2.1+/-1.0 mm), and lagophthalmos (2.0+/-1.2 mm). Eye irritation symptoms and lid functions were improved in all patients. In a survey, the symptomatic, functional satisfaction was achieved in 90% of patients.
CONCLUSIONS
The augmented lateral tarsal strip is a sufficiently effective surgical procedure to be considered in the treatment of paralytic ectropion in leprosy patients.

Keyword

Augmented lateral tarsal strip; Leprosy; Paralytic ectropion

MeSH Terms

Ectropion
Eye
Humans
Keratitis
Leprosy
Reflex

Figure

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  Figure 1. Diagram (1) & photograph (2) demonstrating the technique; (A) Lateral canthotomy and cantholysis. Formation of a long lateral tarsal strip; (B) The anterior and posterior lamella of the upper eyelid is split. Excision of a small triangular area of the upper anterior lamella is performed. Each posterior lamella of the upper and lower lids is reattached with 8‐0 Vicryl; C) The strip is attached to the superolateral orbital rim, overlapping the upper lateral eyelid; D) Orbicularis and skin are sutured with 6‐0 Prolene.

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  Figure 2. Photographs of patients before and after surgery; (A-1) Preoperative view of the patient with paralytic ectropion of the left eye; (B-1) Preoperative view of the patient with paralytic ectropion of the right eye; (A-2, B-2) Six-month postoperative view.

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  Figure 3. Analysis of the palpebral aperture (pal.), margin reflex distance 2 (MRD2), lagophthalmos (Lago.) before and after surgery at 3 and 6 months.

Reference

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