J Korean Ophthalmol Soc.  2016 Mar;57(3):347-352. 10.3341/jkos.2016.57.3.347.

Effectiveness of Combined Surgery Simultaneously Correcting 3 Main Causes of Involutional Entropion

• Yang SW
• Park JH
• Lee JS
• Lee H
• Baek SH

• KMID: 2213234
• DOI: http://doi.org/10.3341/jkos.2016.57.3.347

Abstract

PURPOSE
To evaluate the long-term effectiveness of inferior retractor tightening combined with lateral tarsal strip surgery and anterior lamellar resection for simultaneously correcting the 3 main causes of involutional entropion.
METHODS
In this retrospective study we reviewed 80 patients diagnosed with involutional entropion between April 2004 and February 2014 at the Korea University Guro Hospital and Cheonan Chungmu Hospital. The patients were evaluated for the 3 major causes of involutional entropion and were confirmed to have all components. Lateral canthal tendon laxity test and anterior lamellar redundancy test were performed to grade the involutional entropion patients. The patients received inferior retractor tightening, lateral tarsal strip operation and anterior lamellar resection procedure simultaneously.
RESULTS
Eighty involutional entropion patients were included in the present study. The patients consisted of 35 males and 45 females with an average age of 71.1 ± 9.3 years. In the lateral canthal tendon laxity test, 52 (61.2%) eyes were grade II, 33 (38.8%) eyes were grade III. In the anterior lamellar redundancy test, 17 (20%) eyes were grade I, 57 (67.1%) eyes were grade II and; 11 (12.9%) eyes were grade III. Among the 80 patients, 85 eyelids received combined surgery, 84 had successful outcomes and 1 case recurred at 5 months following the primary surgery with an average follow up of 26.5 ± 4.6 months. Lateral canthal deformity was observed in 2 eyelids which were corrected successfully.
CONCLUSIONS
Simultaneous correction of the 3 main causes of involutional entropion through inferior retractor tightening, lateral tarsal strip surgery and anterior lamellar resection procedure is effective in correcting involutional entropion and safe in avoiding overcorrection.

Keyword

Combined surgery; Entropion; Involutional

MeSH Terms

Chungcheongnam-do
Congenital Abnormalities
Entropion*
Eyelids
Female
Follow-Up Studies
Humans
Korea
Male
Retrospective Studies
Tendons

Figure

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  Figure 1. Combined surgery procedure correcting three main causes of involutional entropion: (A) Preoperative photograph. (B) Disinserted inferior retractor is reattached to the inferior margin of the tarsal plate with 6-0 prolene.(C) Lateral canthotomy and cantholysis are perform ed. (D) 4-0 vicryl suture placed in the tarsal strip. (E) Redundant lid skin and muscle tissues are excised. (F) Postoperative photograph.

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  Figure 2. Long-term follow up of combined surgery procedure. (A) Preoperative photograph. (B, C) Postoperative photographs (each for 1 month and 6 months after inferior retractor tightening combined with lateral tarsal strip procedure and with anterior lamellar resection).

Reference

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