Background This study evaluated the outcomes of a new modified Wies technique for patients with involutional lower eyelid entropion without horizontal eyelid laxity.Methods This case series retrospectively analyzed consecutive patients with entropion who underwent surgery between January 2014 and March 2019 by the same experienced surgeon. Horizontal eyelid laxity, lower eyelid retractor function, and orbicularis muscle overriding were recorded before and after surgery. The recurrence rate and complications were also evaluated. This technique consisted of modified everting sutures combined with reattachment of the lower eyelid retractors to the inferior tarsal plate.Results This new technique was performed on 28 eyes in 25 patients (mean age, 71.0±8.0 years; range, 56–87 years). Nine patients (36%) were women and 16 (64%) were men. Lower lid entropion was present in the right eye in 14 patients (56%), the left eye in eight patients (32%), and both eyes in three patients (12%). The mean follow-up period was 27.3±12.4 months (range, 6–60 months). No intraoperative complications were observed. All patients’ symptoms were alleviated. One patient (3.6%) had recurrence after 2 years (success rate, 96.4%). The remaining 27 eyes maintained a satisfactory and comfortable eyelid position. No patients had problems with scarring.Conclusions The approach described herein proved to be safe and feasible in eyes with involutional lower eyelid entropion without horizontal eyelid laxity. These advantages of this procedure include the lack of a conjunctival scar, punctal eversion, and lateral canthal angle deformation. A low recurrence rate and a long interval to recurrence were also observed.
Purpose: To compare the central corneal thickness (CCT) measurements measured by using the Pentacam Scheimpflug system with the CCT measured using ultrasound pachymetry (UP) and to compare the compatibility between the methods in normal, keratoconic, and cross-linked keratoconic corneas. Methods: The study included 50 eyes of 50 patients with keratoconus (keratoconus group), 50 eyes of 50 patients with progressive keratoconus who underwent corneal cross-linking treatment (CCL group), and 50 eyes of 50 healthy subjects (control group). Patients in the keratoconus and CCL groups were further classified into mild (mean keratometry [Km] ≤ 47 D) and moderate keratoconus subgroups (47.0 < Km < 52.0 D). CCT values were noted from the Pentacam Scheimpflug and UP. Results: The difference between the Pentacam and UP values was largest in the CCL group (−20.9 0.21.5 μm), followed by the keratoconus and control groups (−10.6 0.20.3 and 0.4 0.6.8 μm). The Pentacam and UP measurements were not comparable in the keratoconus and CCL groups (P = 0.001 and P < 0.001), whereas they were comparable in the control group (P = 0.62). In subgroup analysis, the 2 methods were comparable in the mild keratoconus subgroup (P = 0.12) and not comparable in the moderate keratoconus subgroup and in both mild and moderate subgroups of the CCL group (P = 0.001, P < 0.001 and P < 0.001). Conclusions: Pentacam Scheimpflug tomography and UP can be used interchangeably in normal and mild keratoconic eyes, but not in moderate keratoconic and cross-linked keratoconic eyes. Pachymetry measurements from Scheimpflug must be interpreted with extreme caution with different methods before planning an invasive procedure in these eyes.
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