A retrospective study of tailored surgery based on the mechanical balance principle for involutional entropion in the lower eyelid

2020 ◽  
pp. 112067212098439
Author(s):  
Jian Hu ◽  
Yueyue Li ◽  
Qian Li ◽  
Liqiang Wang ◽  
Yifei Huang
Keyword(s):  
Retrospective Study ◽  
Wedge Resection ◽  
The Elderly ◽  
Lower Eyelid ◽  
Recurrence Rates ◽  
Balance Principle ◽  
Involutional Entropion ◽  
Balance Analysis ◽  
Lateral Tarsal Strip

Objective: Involutional entropion in the lower eyelid is one of the most common eyelid disorders of the elderly. Despite the effectiveness of the widely used surgical procedures, recurrence rates have failed to improve. In this retrospective study, we aimed to assess surgical plans, effectiveness and safety of tailored surgery based on the mechanical balance principal in treating involutional entropion in the lower eyelid. Methods: A retrospective analysis of 47 patients (54 eyelids) diagnosed with involutional entropion in the lower eyelid and receiving tailored surgical treatment based on mechanical balance principle from 1 January 2016 to 31 December 2018 was carried out. Tailored surgical plans were developed according to the mechanical balance analysis of vertical, horizontal and sagittal directions. Results: All 54 eyelids with involutional entropion in the lower eyelid underwent advancement of the lower eyelid retractor (LER) through the conjunctiva. For patients with mild horizontal eyelid laxity, only LER advancement was performed. For moderate and severe horizontal eyelid laxities, combined horizontal reinforcement procedures were performed, including lateral canthopexy, lateral tarsal strip (LTS) surgery and wedge resection. The orbicularis oculi muscle (OOM) tightening or transposition was performed for OOM overriding. The follow-up time was 1 to 4 years, and there were no cases experiencing recurrence. Thus, the rates of effectiveness and recurrence were 100% and 0%, respectively. Conclusions: This is the first descriptive study on the tailored surgical strategies designed according to the mechanism of mechanical imbalance involved in involutional entropion. Tailored surgery based on the mechanical balance principle is safe and effective with low recurrence.

scholarly journals Synchronous Surgical Treatment of Lower Eyelid Involutional Entropion and Ptosis

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
D. Vasakos ◽  
E. Nakos ◽  
C. Sioulis
Keyword(s):  
Treatment Options ◽  
The Elderly ◽  
Lower Eyelid ◽  
Postoperative Recovery ◽  
Multiple Time ◽  
Upper Eyelid ◽  
Alternative Treatment Strategy ◽  
Involutional Entropion ◽  
Lateral Tarsal Strip ◽  
Upper Eyelid Ptosis

Background. Involutional entropion and upper eyelid ptosis are common eyelid diseases in the elderly population. They represent a frequent cause of discomfort and often result in significant visual and functional impairment. The surgical management of these disorders includes various treatment options and techniques and is usually carried out in multiple time sessions. Case Report. We report the case of a 72 year old female patient, suffering from right eye involutional lower eyelid entropion and ptosis, who was treated synchronously for both conditions, by applying the lateral tarsal strip procedure and the levator resection technique. Conclusion. The synchronous treatment of involutional entropion and ptosis is an alternative treatment strategy, which could potentially improve surgical outcome, while reducing postoperative recovery time and treatment costs.

Lateral tarsal strip through osteotomies for recurrent ectropion and eyelid laxity correction

2022 ◽  
pp. 112067212110730
Author(s):  
Amparo M Mora ◽  
Carlos M Córdoba ◽  
Fabio D Padilla ◽  
Diego F Duran
Keyword(s):  
Surgical Technique ◽  
Facial Asymmetry ◽  
Lower Eyelid ◽  
Body Sensation ◽  
Alternative Treatment Option ◽  
Initial Symptoms ◽  
Aesthetic Results ◽  
Lateral Tarsal Strip ◽  
Anophthalmic Socket

Objective to present a surgical technique for treating patients with recurrent ectropion and severe lower eyelid laxity. Methods Lateral tarsal strip and canthal fixation by osteotomy was performed in 6 patients with recurrent ectropion and 1 patient with extreme lower eyelid laxity secondary to an anophthalmic socket. Preoperative and postoperative photographs were evaluated in order to assess the outcomes of the procedure. Patients were followed up 4 weeks, 6 months, 12 months and 24 months of the postoperative period. The initial symptoms of the patients were eye redness, epiphora, foreign body sensation, aesthetic complaints, and facial asymmetry. Symptoms and aesthetic results were assessed by questioning, photographs, and fluorescein and lissamine green stains taken in each visit. Results No postoperative complications were observed. No recurrence episodes were reported during the follow-up period and physical appearance improvement and symptom severity reduction were maintained during the observation. Conclusion Lateral tarsal strip through osteotomies is an effective surgical procedure for treating severe recurrent ectropion cases or lower eyelid laxity and could be considered as an alternative treatment option or even a primary surgical technique in selected difficult cases.

Involutional Entropion and Ectropion of the Lower Eyelid: Prevalence and Associated Risk Factors in the Elderly Population

2011 ◽  
Vol 27 (5) ◽  
pp. 317-320 ◽  
Author(s):  
Renato Wendell Damasceno ◽  
Midori Hentona Osaki ◽  
Paulo Elias Correa Dantas ◽  
Rubens Belfort
Keyword(s):  
Risk Factors ◽  
Elderly Population ◽  
The Elderly ◽  
Lower Eyelid ◽  
Involutional Entropion ◽  
Associated Risk Factors

scholarly journals Percutaneous Endoscopic Lumbar Discectomy for Lumbar Disc Herniation with Modic Changes via a Transforaminal Approach: A Retrospective Study

2019 ◽  
Vol 6 (22;6) ◽  
pp. E601-E608
Author(s):  
Ya-Wei Li
Keyword(s):  
Back Pain ◽  
Retrospective Study ◽  
Lumbar Disc ◽  
Leg Pain ◽  
Recurrence Rates ◽  
Transforaminal Approach ◽  
Modic Type ◽  
Endoscopic Lumbar Discectomy

Background: The surgical selection for patients with lumbar disc herniation (LDH) with Modic changes (MCs) is still contentious. Percutaneous endoscopic lumbar discectomy via a transforaminal approach (TF-PELD) as a representative minimally invasive spine surgery technique for LDH has been standardized. However, its efficacy has not been thoroughly described in the patients with LDH with MCs. Objectives: The goal of this study was to assess the clinical outcomes of TF-PELD in the treatment of LDH and MCs. Study Design: Retrospective study. Setting: Inpatient surgery center. Methods: From January 2015 to December 2016, 276 patients with LDH showing normal or MCs signals in their bone marrow in our hospital were enrolled in this retrospective study. All patients suffered low back and leg pain because of LDH and underwent the TF-PELD procedure. Clinical outcomes were assessed according to the Visual Analog Scale (VAS) for back pain and leg pain, Oswestry Disability Index (ODI) for functional status assessment, and modified MacNab criteria for patient satisfaction. Results: A total of 182 patients showed normal intensity, 44 patients showed Modic type 1 signals, and 50 patients showed Modic type 2 signals before surgery. The postoperative VAS and ODI scores were significantly improved compared with those preoperatively among the groups. In the Modic type 1 and 2 signals groups, however, the postoperative VAS scores for back pain and ODI scores showed an upward trend with the follow-up time extending. The recurrence rates were 4.4%, 9.1%, and 8.0% in the normal, Modic type 1 and 2 signals groups, respectively. The recurrence rates and satisfaction rates showed no significant difference among the groups at the final follow-up. Limitations: This study has a small sample size and the follow-up period was too short. There is no comparison with other therapeutic options such as fusion surgery or the lack of any other treatment. Conclusions: TF-PELD is an option for treatment of patients with LDH even if the patients show MCs. However, the postoperative back pain and functional status have the trend of deterioration with the time extending in patients with MCs, especially in the Modic type 1 signals

P–303 Similar long term recurrence rates with cystectomy and CO2-laser vaporization for endometrioma: a retrospective study

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
N Moura. Tawfic ◽  
C Bafort ◽  
C Meuleman ◽  
A Laenen ◽  
D Va. Schoubroeck ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Co2 Laser ◽  
Reproductive Age ◽  
University Hospital ◽  
Laser Vaporization ◽  
Recurrence Rates ◽  
Laparoscopic Excision ◽  
Cyst Recurrence ◽  
The Mean

Abstract Study question Is there a difference in recurrence rate of endometrioma(s) after cystectomy versus CO2-laser vaporization of the cyst wall? Summary answer Similar rates of imaging based recurrence or need for reintervention for endometrioma were observed after cystectomy versus CO2-laser vaporization. What is known already Surgical treatment of endometrioma(s) is mainly performed by 2 types of procedures: cystectomy and ablation. When performing surgery for endometrioma(s), a balance should be made between minimal destruction of normal ovarian cortex and maximal completeness to avoid (early) recurrence. Previous studies have shown that cyst recurrence rates were higher with ablation using bipolar current than after cystectomy. However, only 2 groups have evaluated recurrence rates after cystectomy versus CO2 laser vaporization and found no difference with extended follow-up. Furthermore, ablation with CO2 laser may be less invasive than conventional cystectomy with increased preservation of antral follicles in favor of ablation. Study design, size, duration Single-center retrospective study on data of 271 patients operated between January 2010 and December 2014. Participants/materials, setting, methods Women of reproductive age (18–45 years), undergoing CO2 laser laparoscopic excision of any rAFS-stage endometriosis with at least one endometrioma, were eligible for the study. All 271 included patients were treated in a tertiary referral center for endometriosis of a University Hospital, and underwent complete CO2-laser laparoscopic surgery for endometrioma(s). 155 underwent cystectomy, 77 CO2 laser vaporization, and 46 a mixed technique. Main results and the role of chance The mean duration of follow-up was 58 months. Primary outcome studied was the comparison of recurrence rates between cystectomy and vaporization; secondary outcomes included pregnancy rate and ovarian reserve testing. Recurrence was defined as either imaging based (i.e. cyst recurrence identified at ultrasound and/or MRI) or need for reintervention for suspected cyst recurrence. Imaging based recurrence was reported in 9.92% of patients (n = 12/121) treated with cystectomy and in 11.76% of patients (n = 6/51) who underwent a CO2 laser vaporization (p = .62). The need for reintervention for endometrioma(s) was also similar in both groups, with a rate of 3.23% (n = 5/155) after cystectomy and 4.29% (n = 3/70) after CO2 laser vaporization (p = .567). No difference was seen regarding AMH drop pre- versus postoperatively (p=.233). The 2 study groups were similar, except for the mean cyst diameter, which was higher in the cystectomy group (42.36 ± 25.49 mm) compared to the CO2 laser vaporization group (31.7 ± 26.98 mm) (p = <.001). This suggests that smaller endometriomas might be more likely to undergo CO2 laser vaporization. Limitations, reasons for caution The retrospective character of the study may induce information bias concerning the registration of recurrence. Moreover, regarding the evaluation of imaging-based recurrence, a selection bias cannot be excluded, because most likely only patients complaining about pain would be referred for an ultrasound or planned for a reintervention. Wider implications of the findings: In this study, similar rates of recurrence for endometrioma(s) were observed after cystectomy versus CO2-laser vaporization. Since previous studies suggested that CO2-laser vaporization may cause less damage to the adjacent ovarian tissue, we consider this a valuable alternative technique, especially for women with a future child wish. Trial registration number S59032

Comparison of mechanochemical ablation versus ligation and stripping for the treatment of incompetent small saphenous vein

2021 ◽  
pp. 026835552110451
Author(s):  
Luca Apruzzi ◽  
Victor Bilman ◽  
Vincenzo Ardita ◽  
Nicola Favia ◽  
Concetta Saracino ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Pain ◽  
Return To Work ◽  
Saphenous Vein ◽  
Neurological Symptoms ◽  
Recurrence Rates ◽  
Early Return ◽  
Mechanochemical Ablation

Objective to compare the outcomes of mechanochemical ablation (MOCA) versus saphenopopliteal junction ligation and stripping (OS) for symptomatic small saphenous vein (SSV) insufficiency. Methods This is a retrospective study including symptomatic SSV patients treated with MOCA using the ClariVein catheter (Merit Medical, South Jordan, Utah, USA) or OS from 2015 to 2019. Results A total of 60 limbs (73.3% women, mean age 54.7 ± 14.4 years) were treated with MOCA and 58 limbs (63.8% women, mean age 54 ± 11.6 years) with OS. At 18 months follow-up, recurrence rates were 7.5% (4/53) for MOCA vs. 5.7% (3/52) for the OS group. MOCA group was associated with less pain at first postoperative day, and an early return to work (MOCA 3.5 ± 2.3 days vs. OS 14.2 ± 3.8 days, p < .0001). No cases of leg paresthesia/dysesthesia were observed in the MOCA group, while two patients (3.4%) presented neurological symptoms after OS treatment. Conclusion MOCA and OS are both safe and effective techniques for symptomatic SSV insufficiency. MOCA group demonstrated to be associated with less postoperative pain and early return to work compared to OS.

scholarly journals Stades method for surgical correction of upper eyelid trichiasis-entropion: results and follow-up in 21 cases

2000 ◽  
Vol 30 (4) ◽  
pp. 651-654
Author(s):  
José Luiz Laus ◽  
Felipe António Mendes Vicenti ◽  
Aline Adriana Bolzan ◽  
Paula Diniz Galera ◽  
Rodrigo Cezar Sanches
Keyword(s):  
Retrospective Study ◽  
Lower Eyelid ◽  
Normal Function ◽  
Surgical Correction ◽  
Upper Eyelid ◽  
Facial Mask ◽  
Maximum Period ◽  
Ocular Signs

Trichiasis is a condition in which lhe cuia and facial hairs grow toward lhe córnea or the conjunctiva. The hairs arising from normal sites are pointed aí an abnormal direction. This condition may be caused by prominent nasal folds, entropion, blepharospasm, slipped facial mask and dermoids. The upper eyelid trichiasis-entropion with lower eyelid entropionectropion frequentiy occurs in oíder English Cocker Spaniels. The ocular signs often are epiphora, blepharospasm, conjunctivitis, keratitis and comeal ulceratíon. Treatment depenas on the severity ofthe condition and must eliminate the ocular contact by misdirected cuia that irritate the eyeball. This report presents a retrospective study of21 patients with bilateral diffüse trichiasis (15 English Cocker Spaniels; 2 Basset hounds; l Bloodhound; l Fila Brasileiro and 2 mongrel dogs). The procedure described by Stades was employed m ali cases. Postoperatively, topical chioramphenicol oiníment (qid) was appiied in the conjunctival soe and on the open woundfor 2 weeks. Sutures were removed 10 days after surgery. Correction ofpositioning ofthe upper eyelid was successfúl and its apposition to córnea was normal. In most of the cases the reepithelialiwtion was complete one month after surgery. No signs ofrecurrence werefound and there appeared to be no loss of normal fünction of the eyelid in the 21 dogs available for follow-up examination in a maximum period of 36 months.

Lateral tarsal strip plus skin-muscle flap excision in the treatment of lower eyelid involutional entropion

Orbit ◽  
2017 ◽  
Vol 36 (6) ◽  
pp. 375-381 ◽  
Author(s):  
Kristen E. Dunbar ◽  
Catherine Cox ◽  
Katrinka L. Heher ◽  
Mitesh K. Kapadia
Keyword(s):  
Muscle Flap ◽  
Lower Eyelid ◽  
Involutional Entropion ◽  
Lateral Tarsal Strip

Branchial Anomalies in the Pediatric Population

2007 ◽  
Vol 137 (2) ◽  
pp. 289-295 ◽  
Author(s):  
James W. Schroeder ◽  
Nadia Mohyuddin ◽  
John Maddalozzo
Keyword(s):  
Retrospective Study ◽  
Surgical Treatment ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Tertiary Care ◽  
Epithelial Lining ◽  
Pediatric Hospital ◽  
Recurrence Rates ◽  
Branchial Anomalies

OBJECTIVE: We sought to review the presentation, evaluation, and treatment of branchial anomalies in the pediatric population and to relate these findings to recurrences and complications. STUDY DESIGN AND SETTING: We conducted a retrospective study at a tertiary care pediatric hospital. PATIENTS: Ninety-seven pediatric patients who were treated for branchial anomalies over a 10-year period were reviewed. Patients were studied if they underwent surgical treatment for the branchial anomaly and had 1 year of postoperative follow-up; 67 children met criteria, and 74 anomalies were studied. RESULTS: Patients with cysts presented at a later age than did those with branchial anomaly fistulas or sinus branchial anomalies. 32% of branchial anomalies were previously infected. Of these, 71% had more than one preoperative infection. 18% of the BA were first arch derivatives, 69% were second arch derivatives and 7% were third arch derivatives. There were 22 branchial cysts, 31 branchial sinusies and 16 branchial fistulas. The preoperative and postoperative diagnoses differed in 17 cases. None of the excised specimens that contained a cystic lining recurred; all five recurrences had multiple preoperative infections. CONCLUSIONS: Recurrence rates are increased when there are multiple preoperative infections and when there is no epithelial lining identified in the specimen.

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