Cicatricial Ectropion Repair for Dermatologic Surgeons.

Abstract

Cicatricial ectropion occurs when tension of a scar below the eye has sufficient downward pull to evert the lower eyelid. There are many surgical techniques to repair cicatricial ectropion. To review the published literature on the repair of cicatricial ectropion, review relevant anatomy, and review surgical considerations for patients with cicatricial ectropion from the perspective of a dermatologic surgeon. A search of PubMed was conducted to identify articles on cicatricial ectropion repair through December 1, 2017. Articles were individually reviewed for applicability to dermatologic surgery. Forty-one articles were reviewed. Many articles report significant differences in outcomes when comparing 1 cicatricial ectropion repair technique to another; however, 1 single surgical approach has not been shown to be superior to the rest for most patients. There is a lack of consensus among the literature about the optimal approach to repairing cicatricial ectropion. The selection of surgical technique will vary depending on several factors including the lateral or medial extent of the ectropion, the degree of scarring and tissue density of potential donor sites for a skin flap, and the severity of lid laxity.