Algorithm for the management of ectropion through medial and lateral canthopexy

Baek, Siook; Chung, Jae Ho; Yoon, Eul Sik; Lee, Byung Il; Park, Seung Ha

doi:10.5999/aps.2018.00836

Cited by 16 publications

(17 citation statements)

References 20 publications

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“…The choice of appropriate surgical management for lower lid ectropion depends on the type of ectropion observed during preoperative evaluation [ 17 ]. Initially, ectropion should be classified as present or current versus potential or latent, then symptoms should be evaluated, such as lagophthalmos, lid eversion, lid malposition, and lid laxity.…”

Section: Lower Eyelid Correctionmentioning

confidence: 99%

Treatment for ophthalmic paralysis: functional and aesthetic optimization

Kim

2019

Arch Craniofac Surg

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Facial nerve palsy has an effect on a person's well-being functionally and psychologically. Therefore, comprehensive patient management is essential. One of the most common uncomfortable and potentially debilitating features is associated with the incapacity for eye closure. Restoration of eye closure is a key consideration during the surgical management of facial palsy. In this article, we introduce simple surgical methods-which are relatively easy to learn and involve the upper and lower eyelids-for achieving eye closure. Correcting upper eyelid function involves facilitating the component of eye closure that is in the same direction as gravity and is, therefore, less complicated and favorable outcomes than correction of lower lid. Aesthetic aspects should be considered to correct the asymmetry caused by facial palsy. Lower eyelid function involves a force that opposes gravity for eye closure, which makes correction of lower eyelid ectropion more challenging than surgery for the upper eyelid, particularly in terms of effecting a sustained correction. Initially, proper ophthalmic evaluation is required, including identifying the chronicity and severity of ectropion. Also, it is important to determine whether or not lateral canthoplasty is necessary. The lateral tarsal strip procedure is commonly used for lower lid correction. However, effective lower lid correction can be achieved with better cosmesis when extensive supporting techniques are applied, including those involving cheek tissue.

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Section: Lower Eyelid Correctionmentioning

confidence: 99%

Treatment for ophthalmic paralysis: functional and aesthetic optimization

Kim

2019

Arch Craniofac Surg

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“…Evaluation of lower eyelid malpositions plays a vital role in the diagnosing of eyelid disease as well as the designation of surgeries, and the follow-up project is also essential for the evaluation of treatment effects. However, the main evaluation of lower eyelid malpositions, especially the medial canthal malposition is not quantitative due to the limited method [ 38 ]. In our study, with the application of the 3D stereophotography and our landmarks system, the pre-operative malposition could be evaluated quantitatively (Fig.…”

Section: Discussionmentioning

confidence: 99%

Standardized Three-Dimensional Lateral Distraction Test: Its Reliability to Assess Medial Canthal Tendon Laxity

et al. 2021

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Background Assessment of MCT laxity is critical to the surgery options. Our study aimed to analyze the reliability of measuring medial canthal tendon (MCT) laxity by using a novel standardized three-dimensional lateral distraction test (3D-LDT). Methods Forty-eight Caucasian volunteers (25 males and 23 females, 96 eyes) between 22 and 84 years of age (55.6 ± 18.6 years old) were included in our study. From a neutral position, the lower eyelid was gently pulled laterally along a horizontal line to define the most distracted position of the lower punctum. Both in the neutral and distracted position, standardized 3D images were acquired for each subject by two observers, and each image were measured twice by two raters. Four landmarks and six corresponding linear measurements were evaluated for intra-rater, inter-rater, and inter-method reliability. Results Intra-rater, inter-rater and inter-method reliability analyses of 3D-LDT revealed an intraclass correlation of more than 95%, a mean absolute difference of less than 1 mm, and a technical error of measurement of less than 1 mm. Measurements of relative error (2.59–12.04%) and relative technical error (1.83–16.05%) for the inter-landmarks distance from pupil center to the lower punctum were higher than those from limbus nasal center to the lower punctum (6.13–30.39 and 4.34–26.85%, respectively). Conclusions This study provided high reliability of the three-dimensional lateral distraction test (3D-LDT) for assessing medial canthal tendon (MCT) laxity, which were never evaluated by digital imaging system. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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“…In patients with ectropion of the entire length of the eyelid, medial canthopexy should also be performed. 6 Our population represented a challenging cohort where 60% presented with total eversion of the eyelid. Employing the silicone technique brought stability throughout the entire length of the lid and addressed scleral exposure.…”

Section: Discussionmentioning

confidence: 99%

Lateral transorbital canthopexy using a silicone tube in patients with paralytic ectropion

González-Cannata¹,

González-Hinojosa²,

Aguilera-Ruíz³

et al. 2021

European Journal of Ophthalmology

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Purpose: We describe the efficacy of lateral transorbital canthopexy using a silicone tube in managing severe paralytic ectropion. Methods: Patients with paralytic ectropion involving at least two-third of lower eyelid length and scleral exposure of 3 mm or more were considered. A silicone prosthetic was inserted during canthopexy. Results: Lateral transorbital canthopexy using a silicone tube was performed on 10 eyelids in nine patients. All patients had corneal surface abnormalities. Scleral exposure resolved completely in three cases. At 8-month follow-up, residual scleral exposure of 1 mm and 2 mm persisted in n = 6 and n = 1 cases, respectively. Conclusions: Lateral transorbital canthopexy using a silicone tube is an effective therapeutic option for paralytic ectropion, facilitating both functional and cosmetic results that proved durable over time.

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Algorithm for the management of ectropion through medial and lateral canthopexy

Cited by 16 publications

References 20 publications

Treatment for ophthalmic paralysis: functional and aesthetic optimization

Treatment for ophthalmic paralysis: functional and aesthetic optimization

Standardized Three-Dimensional Lateral Distraction Test: Its Reliability to Assess Medial Canthal Tendon Laxity

Lateral transorbital canthopexy using a silicone tube in patients with paralytic ectropion

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