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

Abstract

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.

Lateral Tarsoplasty Combined with a Full-Thickness Skin Graft for Managing Severe Lower Eyelid Ectropion Following the Subciliary Approach for Infra-Orbital Rim Fracture: A Retrospective Observational Study

“…Notably, various surgical options exist for correcting ectropion, and their selection should be tailored to the underlying etiology [ 7 ]. Procedures addressing lower eyelid laxity include lateral musculopexy, canthopexy, canthoplasty, the tarsal strip technique, and wedge resection of the lower eyelid [ 7 , 8 , 9 , 10 , 21 , 22 , 23 , 24 ]. Ectropion due to scar formation in the lower eyelid lamella structures can be managed by removing scar tissue, releasing scar contractures, and subsequent skin replacement [ 7 , 25 , 26 , 27 ].…”

Restoration of the Lateral Canthus and Stabilization of the Lower Eyelid After Failed Esthetic Lateral Canthoplasty

“…Since its original description in the late 1970s, the lateral tarsal strip procedure has remained one of the most practical and commonly performed procedures, particularly in cases of horizontal eyelid shortening, such as involutional or paralytic upper and lower eyelid laxity and lateral canthal tendon laxity 12-20 . Until now, this technique has been readapted for revision of lateral canthal deformity without residual laxity 8 …”

“…Since its original description in the late 1970s, the lateral tarsal strip procedure has remained one of the most practical and commonly performed procedures, particularly in cases of horizontal eyelid shortening, such as involutional or paralytic upper and lower eyelid laxity and lateral canthal tendon laxity. [12][13][14][15][16][17][18][19][20] Until now, this technique has been readapted for revision of lateral canthal deformity without residual laxity 8 As lowering of the lower eyelid procedure could produce downward traction of the lower eyelid, 21 canthal revisions on those patients could be much more complicated and challenging. Three patients who once had to lower the lower eyelid procedure presented with mild lower eyelid retraction and sclera show.…”

The role of the lateral tarsal strip procedure in modern ophthalmic plastic surgery—A review

“…Most of the studies of the LTS are based on classic eyelid measurements, patient observations, two-dimensional (2D) photography analysis, or the surgeon’s observations ( 6 , 9 , 10 ). Stereophotography measurements are more and more common in oculoplastic surgery nowadays, and they are proven to be objective, reproducible, and accurate ( 11 – 14 ).…”