Correction of Congenital Entropion of the Lower Eyelid: Incisional versus Rotational Surgery

Purpose When, at birth, the eyelid margin is rolled inward against the globe, the condition is referred to as congenital entropion. Upper eyelid involvement is commonly associated with a tarsal abnormality, while lower eyelid entropion is often associated with epiblepharon. Entropion does not resolve spontaneously, and may cause corneal pathology if untreated. The purpose of this study is to compare the two common techniques for the correction of congenital entropion. Methods The authors performed a pilot study of 24 consecutive patients with lower bilateral congenital entropion to compare the results of incisional versus rotational surgery. Results The rotational procedure was carried out in 14 patients; incisional surgery was performed in 10 patients. Twenty-one patients had good functional and cosmetic results. There were only three case of relapse after 3, 4, and 3 months. Conclusions The authors consider both techniques satisfactory, but the procedure of choice, considering the age of the patients and previous studies, remains rotational sutures because of its simplicity, quickness, and low risk of complication.

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Correction of paralytic lagophthalmos

Folia Medica ◽

10.2478/v10153-011-0074-x ◽

2012 ◽

Vol 54 (1) ◽

pp. 24-29

Author(s):

George E. Anastassov ◽

Regina H. Khater ◽

Yourii K. Anastassov

Keyword(s):

Lower Eyelid ◽

Technical Note ◽

Temporalis Muscle ◽

Temporalis Fascia ◽

Eyelid Margin ◽

Upper Eyelid ◽

Muscle Transfers ◽

Conchal Cartilage Graft ◽

Gold Weights

ABSTRACT INTRODUCTION: Bell’s palsy causes lagophthalmos of the involved eyelids. Secondary to the atonicity of the eyelids, xerophthalmia, conjunctivitis and epiphora develops. There are dynamic (muscle transfers) and static (gold weights, tarsorrhaphy) approaches to alleviate these problems. The GOALS of this study are to present a technical note for a surgical method for lengthening the retracted upper eyelid with autogenous temporalis fascia and elevation of the lower eyelid with transplantation of autogenous morselized conchal cartilage graft via standard blepharoplasty incisions. MATERIAL AND METHODS: The proposed technique is illustrated in details with an example of a patient with paralytic lagophtalmos. The 4 years follow up of the case operated by this technique shows a stable occlusion of the eyelids with a lowering of the upper eyelid and elevation of the lower eyelid margin. CONCLUSION: If the paralysis is complete this technique will not accomplish adequate relieve of symptoms. In this cases re-animation of the eyelids with either temporalis muscle transfers or free micro neurovascular muscle transfers are indicated.

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Lateral sliding flap for one-step reconstruction of medium-sized eyelid defects

Journal of Clinical Images and Medical Case Reports ◽

10.52768/2766-7820/1069 ◽

2021 ◽

Vol 2 (2) ◽

Author(s):

Dion Paridaens ◽

Keyword(s):

Operating Time ◽

Case Series ◽

Lower Eyelid ◽

Advancement Flap ◽

Eyelid Margin ◽

Upper Eyelid ◽

Reconstruction Methods ◽

Lateral Canthus ◽

One Step ◽

Fair Poor

Background/purpose: To report the results of our clinical study on the efficacy of a ‘Lateral Sliding Flap’: A one-step technique for lower or upper eyelid reconstruction. Methods: Retrospective analysis of a consecutive case series of patients treated with a ‘Lateral Sliding Flap’ following tumour removal by horizontal block excision. In this technique a (medium-sized) defect of up to 50% of the eyelid was reconstructed by disinsertion of the lateral canthus, medial advancement of the lateral (remaining) (full-thickness) eyelid and a laterally-based horizontal skin-muscle advancement flap, followed by canthal fixation. We recorded the operating time and evaluated the postoperative eyelid apposition, lid contour, complications and frequency and type of re-operation. The outcome was scored (according to four grades (excellent/good/fair/ poor) of lid apposition and contour. Results: Seven consecutive patients, all treated by one oculoplastic surgeon in one year, were included. Six were female, one was male. Five had lower eyelid defects, two had upper eyelid defects of 40-50% of the horizontal width. The average age was 67,9 years, ranging from 52 to 85 years. The mean postoperative follow-up time was 31 months, ranging from 21-43 months. The average duration of the reconstruction was 31 minutes (ranging from 25 to 38 minutes). The outcome was excellent in 3 patients, good in 3 patients and fair in one patient. (Some) lash loss may be encountered. No complications such as flap ischemia of necrosis were noted. No re-operation was required. Conclusion: The ‘Lateral Sliding Flap’ is an efficaceous, one-step technique for reconstruction of defects of up to 50% of the lower or upper eyelid. With the technique a normal eyelid margin is created at the level of the cornea for optimal visual function and comfort. Compared to Tenzel’s semicircular rotation flap, the ‘lateral sliding flap’ results in a shorter vertical scar and “Hidden” horizontal scars in the relaxed skin tension lines.

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Amputacija donjeg kapka u terapiji tumora kapaka

Acta chirurgica iugoslavica ◽

10.2298/aci0702075b ◽

2007 ◽

Vol 54 (2) ◽

pp. 75-77

Author(s):

Anica Bobic-Radovanovic ◽

Zoran Latkovic

Keyword(s):

General Condition ◽

Lower Eyelid ◽

Eyelid Margin ◽

Old Patients ◽

Cosmetic Results ◽

Simple Excision ◽

Eyelid Tumors

In carefully selected cases of tumors of the lower eyelid (tumors which destroy more than 40% of the eyelid margin and are not higher then 3mm, in old patients in bad general condition and in the cases of multiple microrecurrences of a tumor) authors suggest simple excision of a tumor without reconstruction of a eyelid. It is an effective method of treatment of the tumor with good functional effects and acceptable cosmetic results. .

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Management of Eyelid Retraction

Surgery of the Eyelid, Lacrimal System, and Orbit ◽

10.1093/oso/9780195340211.003.0015 ◽

2011 ◽

Author(s):

Alexander Taich ◽

Adam S. Hassan

Keyword(s):

Rectus Muscle ◽

Lower Eyelid ◽

Eyelid Retraction ◽

Adrenergic Stimulation ◽

Inferior Rectus ◽

Blurred Vision ◽

Eyelid Margin ◽

Upper Eyelid ◽

Inferior Rectus Muscle ◽

Stimulation Of

Eyelid retraction has numerous causes. Most notably eyelid retraction is caused by thyroid eye disease (TED), trauma, and postsurgical changes. The upper eyelid margin is typically measured at 3.5 to 4.5 mm above the center of the cornea. The lower eyelid margin is typically situated at the inferior border of the limbus. Eyelid retraction is a condition in which the upper eyelid margin is displaced superiorly or the lower eyelid margin is displaced inferiorly. Eyelid retraction may result in exposure keratopathy and disturbing ocular symptoms, including blurred vision, photophobia, foreign body sensation, burning, and reactive tearing. Eyelid retraction in TED is thought to be due to a combination of inflammation, fibrosis, and adrenergic stimulation of the eyelid retractors. Proptosis can also contribute to eyelid retraction. In the upper eyelid, factors responsible for eyelid retraction include (1) inflammation and fibrosis of the levator and Müller’s muscles, (2) adrenergic stimulation of Müller’s muscle, and (3) inflammation and fibrosis of the inferior rectus muscle, causing hypodeviation of the globe and compensatory overaction of the superior rectus–levator complex. In the lower eyelid, factors responsible for eyelid retraction include (1) inflammation and fibrosis of the inferior rectus muscle with consequent traction on its anterior extension, the capsulopalpebral fascia, which is the main lower lid retractor, and (2) adrenergic stimulation of the smooth muscle fibers within the lower lid retractor complex. A combination of eyelid retraction and proptosis in TED may result in ocular exposure with symptoms of ocular irritation, an undesirable cosmetic appearance, corneal erosion and infection, or (rarely) globe luxation. Mild exposure problems can be managed with topical lubricants. Guanethidine, a topical sympatholytic agent, is of limited usefulness in the management of eyelid retraction due to its variable efficacy and frequent ocular side effects, including irritation, hyperemia, photophobia, pain, edema, burning sensation, and punctate keratitis. It may be more tolerable if used in lower concentrations. Exposure problems in the inflammatory phase of the condition present a special challenge as surgical correction of eyelid retraction is best performed in the pos-tinflammatory, stable phase. Several reports have described using Botulinum toxin injections, 2.5 to 15 U, either subconjunctivally or percutaneously, just above the superior border of the tarsus.

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RESULTS OF INTRALESIONAL TRIAMCINOLONE ACETONIDE FOR CHALAZION TREATMENT

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2011.5.13 ◽

2011 ◽

pp. 100-104

Author(s):

Thi Thu Nguyen ◽

Viet Hien Vo ◽

Thi Em Do

Keyword(s):

Success Rate ◽

Key Words ◽

Triamcinolone Acetonide ◽

Lower Eyelid ◽

Upper Eyelid ◽

Interventional Trial ◽

The Mean ◽

First Time

The study use intralesional triamcinolone acetonide injection proceduce for chalazion treatment.1. Objectives: To evaluate results of intralesional triamcinolone acetonide injection for chalazion treatment. 2. Method: This noncomparative prospective interventional trial included 72 chalazions of 61 patients. 3. Results: 61 patients (72 chalazions) with 19 males (31.1%) và 42 females (68.9%), the mean age was 24 ± 9,78 years. 31.1% patients was the first time chalazion and 68.9% patients was more than one times chalazion including 78.6% patients was recurrent at the first position and 21.4% patients occur at new position. 72 chalazions with 16 (22.2%) chalazions was treated before and 56 (77.8%) chalazions wasn’t done that. 72 chalazions with 49 chalazions (68.1%) are local in upper eyelid and 23 chalazions (31.9%) are local in lower eyelid. The mean of chalazion diameter is 6.99 ± 3.03mm. Intralesional triamcinolone acetonide is injected to treat 72 chalazions with 16 (22.2%) chalazions are injected through the route of skin and 56 (77.8%) chalazions are injected through the route of conjunctiva. After 2 weeks follow-up, the success rate was 93.1% and 6.9% failed. 4. Conclusion: intralesional triamcinolone acetonide injection for chalazion treatment is really effective. Key words: chalazion, intralesional triamcinolone acetonide.

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Double Rectangle Fascia Lata Frontalis Sling: A Rationale Approach for Ptosis

Indian Journal of Plastic Surgery ◽

10.1055/s-0041-1723909 ◽

2021 ◽

Vol 54 (01) ◽

pp. 058-062

Author(s):

Pawan Agarwal ◽

Dhananjaya Sharma ◽

Vikesh Agrawal ◽

Swati Tiwari ◽

Rajeev Kukrele

Keyword(s):

Retrospective Study ◽

Surgical Outcomes ◽

Functional Outcomes ◽

Fascia Lata ◽

Modified Technique ◽

Eyelid Margin ◽

Upper Eyelid ◽

Light Reflex ◽

Straight Line

AbstractBackground The purpose of this study was to evaluate the functional outcomes of a modified technique of double rectangle pattern for correction of severe ptosis.Methods This is a retrospective study over a period of 8 years including patients who underwent correction of ptosis by double rectangle using autologous fascia lata sling. Surgical outcomes were assessed postoperatively by distance from the corneal light reflex to the upper eyelid margin (MRD1) and levator function.Results Twenty-six eyelids were operated in 20 patients. There were 9 males and 11 females, with age ranging from 4 to 35 years. Preoperatively, all patients had poor MRD1 and poor levator function. Postoperative MRD1 was good in 13 patients (17 eyelids), fair in 5 (7eyelids), and poor in 2 patients (2 eyelids). Postoperative levator function was excellent in 12 patients (15 eyelids), good in 6 (9 eyelids), and fair in 2 patients (2 eyelids). At a mean follow-up of 12 months, adequate correction was achieved in 24 eyelids, and 2 eyelids had undercorrection.Conclusion Frontalis sling with a double rectangle is simple and more efficient, as it provides a straight line of pull to the eyelid for correction of severe ptosis.

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