Upper lid crease approach for margin rotation in trachomatous cicatricial entropion without external sutures

Abstract

Background: Mostly Upper eyelid cicatricial entropion (UCE) is a common cause of trichiasis which results from pathological process that causes scarring of the tarsus which leads to inward rotation of the lid margin. Objectives: The aim of the present study is to describe the use of lid crease incision for upper eyelid margin rotation in cicatricial entropion combining internal traction on the anterior lamella , tarsotomy , and tarsal overlap without external sutures. Patients and methods: This is a prospective consecutive interventional analytical study that included 40 eyes of 20 patients with age ranging from 40 to 80 years with trachomatous upper eyelid entropion presenting to the outpatient clinic of “Qena ” university hospital , Group patients were randomly selected according to the inclusion criteria to undergo the transcautenous margin rotation operation at qena university hospital &the surgery was explained to the patients . The study was approved by by the scientific and ethical comittees at faculty of medicine ,south valley university Results: The mean patients' age for was (56.0 ± 18.27) and a range of (40.0- 76.0) years , Among the 20 patients recruited, 9 (45%) were males and 11 (55%) were females , In our study, 20% of eyes among the TMR group underwent entropion correction and blepharoplasty for dermatochalasis in the same sitting. Out of 40 eyes in the study, 70% developed grade II and 30% developed grade I post operative lid margin position., Trichiasis recurrence rate was 10% in the studied group Recurrence was seen in four eyelids of four patients despite adequate post operative lid margin position. Conclusion: Upper eyelid cicatricial trachomatous entropion can be effectively managed utilizing the TMR , with no significant incidence in entropion or trichiasis recurrence