Abstract
BackgroundTo evaluate a modified technique for involutional entropion correction in a retrospective cohort study.MethodsThe patients with involutional entropion eyelid were corrected by tightening the pretarsal orbicularis oculi muscle and excising the excess skin of the lower eyelid. The patients received correction surgery from April 2013 to March 2019 were followed up for more than 6 months postoperatively. The outcome measures included the complications and the recurrence rates.ResultsTotal 152 patients (169 eyes) were included. The mean follow-up period was 29.6 months (range: 6–36 months). Postoperative ectropion (over-correction) was observed in 1 patient with 1 eyelid (0.59%); yet, no further surgery was needed for this patient. Recurrence of entropion was found in 1 patient (0.59%). The patient with recurrent entropion received repeated surgery with the same method and achieved a good eyelid position.ConclusionsThis study demonstrated that tightening the pretarsal orbicularis oculi muscle and excising the excess skin of the lower eyelid could be an effective surgical method to correct lower eyelid involutional entropion. This method is technically easy with a low recurrence rate and not associated with significant complications in Asians.
Highlights
To evaluate a modified technique for involutional entropion correction in a retrospective cohort study
We found that the orbicularis muscle fixed in the first surgery moved forward onto the centroid of the lower tarsus, which could be the cause of the recurrence
This study demonstrated that pretarsal orbicularis oculi muscle tightening with skin flap excision was highly effective for the correction of involutional lower eyelid entropion
Summary
To evaluate a modified technique for involutional entropion correction in a retrospective cohort study. Involutional entropion is a condition with eyelid malposition, mainly affecting the lower eyelid, and causes ocular discomfort, epiphora, foreign body sensation and corneal ulceration. The prevalence of involutional entropion among the elderly population is 2.1% and increases with age [1]. Various surgical approaches aim to correct the underlying problems causing entropion, including the Wies procedure, Quickert sutures, lateral tarsal strip procedure, and lower lid retractor reinsertion [5]. In 1938, described an operation for the correction of spastic entropion that a band of orbicularis muscle from the anterior surface of the tarsal plate was dissected, overlapped, and reattached to the tarso-orbital fascia just below the tarsus [6].
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