Ann Dermatol.  2017 Dec;29(6):742-746. 10.5021/ad.2017.29.6.742.

The Lateral Tarsal Strip for Paralytic Ectropion in Patients with Leprosy

• Jue MS
• Yoo J
• Kim MS
• Park HJ

• KMID: 2395182
• DOI: http://doi.org/10.5021/ad.2017.29.6.742

Abstract

BACKGROUND
In patients with leprosy, paralysis of the facial nerve results in the lower eyelid ectropion and lagophthalmos as a sequela even when the leprosy is cured. Paralytic ectropion causes many functional and cosmetic eye problems, leading to blindness if left untreated.
OBJECTIVE
The purpose of this retrospective study is to evaluate the efficacy of surgical correction of paralytic ectropion, the lateral tarsal strip, in patients with leprosy.
METHODS
Between 2010 and 2015, 40 Korean patients (44 eyelids) with paralytic ectropion who had visited Korean Hansen Welfare Association Hospital were treated with the lateral tarsal strip. Four-point patients' global assessment scale, local complications, and recurrence were assessed at the end of follow-up period. The average follow-up period was 12 months.
RESULTS
In the 44 eyelids, recurrence was observed in 5 cases (5/44, 11.4%). There were no serious postoperative complications except mild size discrepancy of both eyes. Most patients were satisfied with the results and mean satisfaction scale was 2.6/3.
CONCLUSION
The lateral tarsal strip is a simple, safe, and effective treatment method for the dermatologic surgeon to correct paralytic ectropion of mild to moderate degree in patients with leprosy.

Keyword

Ectropion; Eyelids; Lateral tarsal strip; Leprosy

MeSH Terms

Blindness
Ectropion*
Eyelids
Facial Nerve
Follow-Up Studies
Humans
Leprosy*
Methods
Paralysis
Postoperative Complications
Recurrence
Retrospective Studies

Figure

• 

  Fig. 1 Ectropion grading scale. (A) Mild degree of ectropion showing minimal lid laxity is seen in the left lower eyelid. (B) Moderate degree of ectropion is seen in the left lower eyelid, and marked degree of ectropion is seen in the right lower eyelid. (C) Extreme degrees of ectropion with corneal opacity are seen in both eyes.

• 

  Fig. 2 The lateral tarsal strip procedure. (A) A lateral canthotomy is performed by using a knife. (B) A lateral tarsal strip is fashioned. (C) The tarsal strip is sutured to the periosteum laterally and superiorly with a 5-0 nylon. (D) Skin closure is being done in layers.

• 

  Fig. 3 (A) Preoperative view shows moderate degree of ectropion in both eyes. (B) Postoperative view showing excellent result.

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  Fig. 4 (A) Preoperative view shows mild degree of ectropion of the left eye. (B) Postoperative view shows good result.

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