A comparison of the lateral tarsal strip with everting sutures and the Quickert procedure for involutional entropion

Abstract

Background/Aims: To provide evidence of statistically significant difference in the surgical outcome of the lateral tarsal strip with everting sutures (LTS + ES) versus the Quickert procedure (QP) in the treatment of involutional entropion. Methods: In a prospective randomized comparative trial, 66 eyelids of 52 patients with primary involutional lower eyelid entropion were recruited. Thirtysix eyelids were randomized to QP, and 30 eyelids were randomized to LTS + ES. Surgery was performed by a single surgeon. Postoperative follow-up was scheduled after 2 weeks, 8 and 14 months. Successful surgery was defined as a normal eyelid position at rest and inability to induce entropion on forced eyelid closure at or before the 14-month follow-up visit. Results: A total of 66 eyelids of 52 patients were enrolled in the study. Three patients did not complete follow-up (1 did not attend the 8 months follow-up visit; 2 did not attend 14 months follow-up visit). Of the 63 patients, a single eyelid [success probability 0.97; confidence interval (CI) 0.92-1] in the QP group and two treated eyelids [success probability of 0.93; CI: 0.85-1] in the LTS + ES group had a recurrence of a lower eyelid entropion after 14 months. There was no statistically significant difference in surgical failure between the LTS + ES versus QP (Log-rank test: p = 0.46). Conclusion: These data provide strong evidence that success rates at 14 months are similar in patients treated with either techniques (LTS + ES versus QP).

Comparison of Outcomes for Triangular Tarsectomy and Limited Orbicularis Myectomy with Lower Lid Retractor Plication Versus Everting Sutures for Involutional Entropion.

“…39 Another study found that the 14-month recurrence rate was only 6.90% among 30 cases of lower eyelid entropion corrected using a combined LTS and ES procedure compared to 2.94% among 34 cases of eyelid entropion corrected via Quickert procedure. 40 No cases of recurrence were observed by Rabinovich et al after LTS with infraciliary sutures in 44 eyes with lower eyelid involutional entropion. 41 In conclusion, a triangular tarsectomy and limited myectomy with lower eyelid retractor plication is a safe and effective procedure for the correction of involutional entropion with minimal or no recurrence.…”

Outcomes of Lateral Tarsal Strip in Conjunction with a Minimal Skin Muscle Excision Underlying Cauterization in Korean Patients with Involutional Entropion

“…Reinforcement of the lower eyelid retractors with transconjunctival buried sutures was performed through a mini-incision in 46 patients, and it reported a 93.5 percent success rate ( 18 ). Furthermore, a 93.1% success rate was reported in a study of lateral tarsal strip with everting sutures ( 19 ), S.C. Lee et al ( 20 ) reported good outcomes in Asian involutional entropion using a new procedure called lateral tarsoligamentous sling with a modified lateral tarsal strip. Only 0.59% recurrence was reported after Pretarsal orbicularis oculi muscle tightening with skin flap excision ( 21 ).…”

A 10-min novel technique for involutional entropion: Mini-incisional continuous ligation everting sutures

“…No effect of horizontal eyelid laxity, which has been pointed out to be a major drawback of everting sutures, on recurrence of entropion is clinically noticeable in this new procedure. With regard to female sex as a risk factor, the tarsal dimensions are smaller in females than in males, 27 and it is well known that atrophy or shrinkage of the tarsal plate plays a role in development of entropion 4 by allowing greater overriding of the orbicularis muscle. Therefore, just as the prevalence of involutional entropion is higher in women than in men (2.4% vs 1.9%), 1 it seems reasonable that there were more recurrences in women.…”