Korean J Ophthalmol.  2005 Sep;19(3):161-167. 10.3341/kjo.2005.19.3.161.

Correction of Lower Lid Retraction Combined with Entropion using an Ear Cartilage Graft in the Anophthalmic Socket

• Moon JW
• Choung HK
• Khwarg SI

• KMID: 754418
• DOI: http://doi.org/10.3341/kjo.2005.19.3.161

Abstract

PURPOSE
To investigate the surgical results of an ear cartilage graft and supplemental procedures for correcting lower lid retraction combined with entropion in anophthalmic patients. METHODS: We reviewed retrospectively the medical records of 7 anophthalmic patients with lower lid retraction and entropion, who received a posterior lamellar ear cartilage graft and one or both of lateral tarsal strip or eyelash-everting procedure between March 1998 and March 2003. Preoperative and postoperative lid and socket statuses were also investigated. RESULTS: Ear cartilage grafts were performed in all 7 patients, lateral tarsal strips in 6, and eyelash-everting procedures in 5. Postoperative follow-up durations ranged from 4 to 28 months (average 12.6 months). Retractions were corrected during follow-up in all patients. There were no cases of entropion immediately after surgery. However, the eyelashes of the lower lid returned to an upright position in 4 patients, but not so severe as to touch the ocular prosthesis, and thus did not require surgical correction during follow up. CONCLUSIONS: Lower lid retraction combined with entropion in anophthalmic patients can be corrected effectively using an ear cartilage graft with selective, supplemental procedures.

Keyword

Anophthalmos; Ear cartilage graft; Eyelash-everting procedure; Lateral tarsal strip; Lower lid retraction combined with entropion

MeSH Terms

Retrospective Studies
Male
Humans
Female
Eyelid Diseases/*etiology/*surgery
Entropion/*etiology/*surgery
Ear Cartilages/*transplantation
Child, Preschool
Child
Anophthalmos/*complications
Adult

Figure

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  Fig. 1 An 11-year-old girl with congenital anophthalmos in the left eye (case 2). (A) At her initial visit to Our clinic, she had been wearing a thick ocular prosthesis for 36 months. Lower lid retraction combined With entropion was observed in the left side. Note mild enophthalmos and the lower eyelash touching the Ocular prosthesis. (B) Just before eyelid surgery and 6 months after enucleation and porous polyethylene Orbital implantation. Enophthalmos was corrected, but lower lid retraction combined with Entropion persisted. (C) Six months after surgical correction of lower lid retraction combined with entropion with ear cartilage graft, lateral tarsal strip, and tarsal suturing of subciliary subcutaneous tissue into the lower tarsus. Retraction and Entropion of the lower eyelid were well corrected.

• 

  Fig. 2 A 19-year-old woman with an enucleated left eye due to retinoblastoma (case 5). (A) At her initial visit to our clinic, upper lid ptosis, enophthalmos, and lower lid retraction combined with entropion were noticed on the left side. (B) Six months after removing an implanted Allen sphere and a large subconjunctival cyst and porous polyethylene implantation prior to eyelid operation. (C) Four months after an ear cartilage graft, lateral tarsal strip and an eyelash-everting procedure, the lower lid retraction had been corrected, even though lower lid entropion persisted. However, this did not touch the prosthesis surface and did not require surgical correction.

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  Fig. 3 Harvested ear cartilage was placed in the space between the inferior border of the lower tarsus and the recessed lower retractor and conjunctiva, and sutured using 6-0 polyglactin.

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  Fig. 4 A 9-year-old girl with an enucleated right eye due to retinoblastoma, who had been wearing an ocular prosthesis for 75 months (case 3). This patient had received orbital radiotherapy. (A) At her initial visit to our clinic, lower lid retraction with entropion and enophthalmos were observed on the right side. (B) One week after an ear cartilage. (C) Twenty-eight months after her surgery this correction was main graft and lateral tarsal strip. Separate eyelash-everting procedures were not performed, as lower lid retraction and entropion were corrected by the ear cartilage graft and lateral tarsal striptained.

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