Correction of involutional entropion with retractor redirection

Abstract

The study aims to report the surgical outcome of a retractor redirection procedure for involutional entropion repair for Asians. The study included all cases diagnosed with involutional entropion and significant ocular irritation who presented from 2008 to 2012. Sixty-seven eyelids in 54 patients were included in this study. All cases were operated on by one surgeon and had a minimum of 12-months follow-up. Success was defined as cases showing no recurrence of entropion with forceful eyelid squeezing postoperatively. A retrospective chart review was performed to assess the success rate, recurrences and complications of the procedure. During a mean follow-up period of 26.2 months (range, 12-53 months), 5 patients died during the study period. Two eyelids (3%) of one patient had a recurrence at 34 months postoperatively. One eyelid (1.5%) with a significant horizontal laxity developed postoperative ectropion and required a secondary horizontal shortening procedure. No other postoperative complications or dissatisfaction were reported. The retractor redirection procedure aims to repair the retractors and prevent orbicularis muscle overriding via inserting the retractors to the anterior lamellae. It yields a long-term success rate of 95.5% and is an effective technique for correcting involutional entropion.

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

“…15 Currently, advancement of the LER is mainly used for correction of vertical laxity, and the postoperative recurrence rate is from 3% to 6.5%. 16,17 This procedure is fast, simple, predictable, and highly successful. 17 In this study, transconjunctival advancement of the LER was performed on all the patients.…”

“…If there is obvious eyelid laxity, the surgery should be performed in combination with horizontal correction to reduce the risk of recurrence of entropion. 16 For the correction of horizontal laxity, there are a variety of procedures, including lateral canthoplasty, LTS, Bick's surgery and wedge resection of the eyelid. Lateral canthoplasty is usually used for those with mild to moderate horizontal eyelid laxity.…”

Characteristics of Entropion Patients at Dr. Mohammad Hoesin General Hospital: A Descriptive Study

“…8 The older a person is, the infection, or inflammation. 13,14 Cicatricial entropion is caused by vertical tarsoconjunctival contracture and internal rotation of the eyelid margin, which results in irritation of the eyeball from inverted cilia or a keratinized eyelid margin. A large amount of force is required to pull the tarsal plate inward.…”

Lower eyelid involutional entropion following cataract surgery

“…In persistent post-operative ptosis, it is perioperative dehiscence of the levator palpebrae superioris (LPS) and/or increased horizontal lid laxity that are generally considered to be the main aetiological factors [14]. Any corresponding insult to the lower eyelid might result in retractor dehiscence or increased horizontal laxity; both key drivers in the development of entropion [2][3][4][5]. Whereas post-operative ptosis is generally reported as being observed immediately after surgery, we found a significant delay in the onset of post-operative entropion.…”

“…Surgical correction is almost always indicated to minimise both patient symptoms and the risk of ocular complications such as chronic conjunctivitis, corneal scarring, microbial keratitis, ulceration and perforation. The main causative factors in the development of involutional entropion are horizontal lower eyelid laxity, lower lid retractor dehiscence and overriding of the preseptal orbicularis oculi onto its pretarsal component [2][3][4][5].…”