Age-Matched, Case-Controlled Comparison of Clinical Indicators for Development of Entropion and Ectropion

Abstract

Purpose. To analyze the clinical findings associated with involutional entropion and ectropion and compare them to each other and to age-matched controls. Methods. Prospective, age-matched cohort study involving 30 lids with involutional entropion, 30 lids with involutional ectropion, and 52 age-matched control lids. Results. The statistically significant differences associated with both the entropion and ectropion groups compared to the control group were presence of a retractor dehiscence, presence of a “white line,” occurrence of orbital fat prolapse in the cul-de-sac, decreased lower lid excursion, increased lid laxity by the snapback test, and an increased lower lid distraction. Entropion also differed from the control group with an increased lid crease height and decreased lateral canthal excursion. Statistically significant differences associated with entropion compared to ectropion were presence of a retractor dehiscence, decreased lateral canthal excursion, and less laxity in the snapback test. Conclusion. Entropic and ectropic lids demonstrate clinically and statistically significant anatomical and functional differences from normal, age-matched lids. Many clinical findings associated with entropion are also present in ectropion. Entropion is more likely to develop with a pronounced retractor deficiency. Ectropion is more likely to develop with diminished elasticity as measured by the snapback test.

Eyelid reconstruction in ophthalmic surgical practice

“…These findings are supported by other studies (2,3,6) and may be explained by the differences of tarsal plate size and axial ocular globe projection between men and women (20,21). The main etiological factors for entropion and ectropion development are lateral and medial canthal tendon laxity, and disinsertion of the lower retractors, therefore surgical techniques with tightening of canthal tendons, horizontal lid shortening, and retractors reinsertion provide the best postoperative results (22,23,24). In the present study, the Quickert procedure was used in 44.7% of entropion cases, horizontal lid shortening combined with everting sutures -in 18.1%, and lateral tarsal stripin 17%, with very good results.…”

Meibomian gland dysfunction with involutional eyelids malposition

“…5. Признаки несостоятельности прикрепления сухожилий ретракторов нижнего века [25,29]: глубокий нижний свод, отсутствие складки нижнего века, высокое положение нижне-го века в состоянии покоя, наличие белой линии в нижнем конъюнктивальном своде (несостоятельность сухожилия ретракторов), V-образное соединение ретракторов нижнего века с нижним краем хряща. Показатели состояния мейбомиевых желёз были разделены на несколько групп и оценива-лись по балловой системе в соответствии с реко-мендациями Международного симпозиума по изу-чению мейбомиевой дисфункции (The International Workshop on Meibomian Gland Dysfunction, 2011).…”

Optimization of Diagnosis and Surgical Treatment of Involutional Entropion of the Lower Eyelid

“…Bilateral disease affects three times as many people as unilateral disease. This was found more commonly in women than in men because women's tarsal plates are smaller [4].…”