J Korean Ophthalmol Soc.  2012 Feb;53(2):187-192.

Involutional Ectropion Repair with the Modified Medial Spindle and the Lateral Tarsal Strip Procedure

• Ko SJ
• Kim SD

Abstract

PURPOSE
To evaluate the effects of the modified medial spindle and the lateral tarsal strip procedure in involutional ectropion patients.
METHODS
The lateral tarsal strip procedure with the modified medial spindle procedure that adjusts the size and the position of the spindle along the severity of lower eyelid eversion was performed on 17 eyes of 12 patients with involutional ectropion. The average follow-up period was 19.6 months.
RESULTS
All 12 patients were male, and the mean age was 65.4 years (range 54 to 78 years). There was no recurrence in any of the 17 eyelids. However, a mild lower lid retraction and a mild punctal eversion not requiring reoperation occurred in the follow-up period.
CONCLUSIONS
The lateral tarsal strip procedure combined with the modified medial spindle appears to be effective in the surgical treatment of involutional ectropion.

Keyword

Involutional ectropion; Lateral tarsal strip; Modified medial spindle

MeSH Terms

Ectropion
Eye
Eyelids
Follow-Up Studies
Humans
Male
Recurrence
Reoperation

Figure

• 

  Figure 1 Surgical procedures in repairing right lower eyelid involutional ectropion. (A) A diamond-shaped fusiform wedge of the conjunctiva and lower eyelid retractor was excised inferior to the lower margin of the tarsal plate, depending on the degree of lower lid eversion using Ellman Surgitron F.F.P.F®. (B) The defect of the conjunctiva was closed with a double-armed 5-0 polyglactin (Vicryl®). The 1-3 point suture depending on the size of conjunctival defect was initially passed through the retractor at the lower edge of the incision in a backhanded pass, then uniting the tarsal plate and conjunctiva on the upper edge. After both arms of the suture is pulled superiorly, joining the edge of the lower border of the incision. And then the suture is passed full-thickness through the eyelid. (C) The cantholysis was performed using Ellman Surgitron F.F.P.F®, releasing lower eyelid completely from its attachment to the lateral canthal tendon, and the periosteum of the lateral orbital wall was exposed. (D) The tarsal strip was sutured to the periosteum on the inner aspect of the lateral orbital wall with double-armed 5-0 polyglactin (Vicryl®). (E) the suture tension was adjusted as needed to invert the lower lid margin to the proper position, the suture was tied on the skin surface.

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  Figure 2 (A) Preoperative photograph showing lower lid tarsal ectropion in the left eye. (B) Photograph showing correction of lower lid tarsal ectropion at postoperative 3 years.

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