Anterior Lamellar Recession for Treatment of Cicatricial Entropion with or Without Blepharoplasty

Abstract

Background: Entropion is an inward rotation of the eyelid margin. It is one of the most common lid malposition encountered in clinical practice. There are four types of entropion: congenital, cicatricial, involutional and acute spastic. The pathophysiology of each of these types is different, and so is the treatment. Objectives: To compare between anterior lamellar recession with blepharoplasty and without blepharoplasty. Patients and Methods: Twenty cases of cicatricial entropion by anterior lamellar recession with age range age from 35-75 years were included in this study which was performed at Al-Azhar University Hospitals divided into two equal groups: Group (A): with upper eyelid cicatricial entropion had an anterior lamellar recession by gray line split technique and Group (B) with upper eyelid cicatricial entropion had an anterior lamellar recession by gray line split technique and blepharoplasty. Result: In Group A, we had one case of recurrence observed after 3 months (10%) while in group B no cases of recurrence observed after 3 months (0%), In group A, success rate was 90%, and final aesthetic outcome was 30%, while in Group B success rate was 100%, and final aesthetic outcome was 80%, group B showed less post-operative complication than group A. Conclusions: Combining the procedure of anterior lamellar recession with grey line split technique with blepharoplasty in surgical correction of upper eye lid cicatricial entropion has excellent both functional and aesthetic outcome, and a higher success rate with minimal complication than anterior lamellar reposition only, as simultaneous correction of associated lid laxity and dermatochalisis maximize the efficacy of ALR and enhance the postoperative cosmesis.