Inverting Sutures for Tarsal Ectropion (The Leicester Modified Suture Technique)

Berry-Brincat, Antonella; Burns, J. A.; Sampath, Raghavan

doi:10.1097/iop.0b013e3182a22ad1

“…10 However, their study was limited by the a small sample size of 6 patients and a mean follow-up time of only 4 weeks. Berry-Brincat et al 4 proposed the use of rotational sutures for the correction of tarsal ectropion and added a lateral tarsal strip procedure for cases with horizontal laxity. In their series of 25 eyelids in twenty patients, 17 (68%) underwent both procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment success was based on the criteria used by Berry-Brincat et al, defined by improved eyelid position, improvement of symptoms, and the need for reoperation (Table 1). 4 This study was reviewed and approved by the Institutional Review Board of SUNY Downstate Medical Center. The research adhered to the tenets of the Declaration of Helsinki, and the Health Insurance Portability and Accountability Act.…”

Section: Methodsmentioning

confidence: 99%

Tarsal Ectropion Repair With Modified Bick Eyelid Tightening and Inverting Sutures

Wang

¹

,

Deng

²

,

Shinder

³

2022

Ophthalmic Plastic &Amp; Reconstructive Surgery

0

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The authors report on a 10-year experience of correcting tarsal ectropion using a combined method of modified Bick eyelid tightening (MBLT) and inverting sutures.Methods: Retrospective, interventional case series of consecutive patients with tarsal ectropion who underwent MBLT and inverting sutures by a single surgeon (RS) between July 2010 and July 2020. Thirty-four patients, 24 of whom were female, with a mean age of 81.6 years (range 59-92) were included. Eight patients had bilateral disease. All procedures were performed under local anesthesia in an office setting. Treatment success was defined by eyelid position, symptoms, and need for reoperation.Results: Thirty-one patients (91%) had a successful outcome. Three patients (9%) had satisfactory results with improved symptoms and mild residual ectropion, for which further surgery was not required. No patients had poor results. The mean follow-up time was 4.5 months (range 3-11 months). The inverting sutures were well tolerated in all cases and none had to be removed due to ocular surface discomfort. There were no visible scars from the inverting sutures in any patient at postoperative month 3.Conclusions: A combination of eyelid tightening using MBLT and inverting sutures is a simple and effective treatment for lower eyelid tarsal ectropion with minimal tissue dissection.

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“…Reduced tear meniscus lower than 0.2 mm is suggestive for diminished tear production, while increased height suggests obstruction to the nasolacrimal system (punctual obstruction, canalicular stenosis or nasolacrimal duct obstruction). 27,28 thereby increasing the measurement's reliability and sensitivity. 9,29 Schirmer test is performed to investigate for tear deficiency DED.…”

Section: Clinical Examinationmentioning

confidence: 99%

“…Botulinum toxin injection on the upper eyelid or amniotic membrane transplantation could also protect the cornea and rescue an impending perforation in severe DED. 27,28,49…”

Section: Management Of Dry Eye Diseasementioning

confidence: 99%

Dry Eye and Clinical Disease of Tear Film, Diagnosis and Management

Achtsidis¹,

Kozanidou²,

Bournas³

et al. 2014

US Ophthalmic Review

1

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Dry eye disease (DED) is a clinically significant multifactorial disorder of the ocular surface and tear film as it results in ocular discomfort and visual impairment and predisposes the cornea to infections. It is important for the quality of life and tends to be a chronic disease. It is also common, as the prevalence is estimated between 5 % to 30 % and this increases with age. Therefore, it is recognized as a growing public health problem that requires correct diagnosis and appropriate treatment. There are two main categories of DED: the deficiency of tear production (hyposecretive), which includes Sjögren’s syndrome, idiopathic or secondary to connective tissue diseases (e.g. rheumatoid arthritis), and non-Sjögren’s syndrome (e.g. age-related); and the tear evaporation category, where tears evaporate from the ocular surface too rapidly due to intrinsic causes (e.g. meibomian gland disease or eyelid aperture disorders) or extrinsic causes (e.g. vitamin A deficiency, contact lenses wear, ocular allergies). Management of the disease aims to enhance the corneal healing and reduce patient’s discomfort. This is based on improving the balance of tear production and evaporation by increasing the tear film volume (lubrication drops) and improving quality of tear film (ex omega-3 supplements, lid hygiene, tetracyclines), reducing the tear film evaporation (paraffin ointments, therapeutic contact lenses), reducing tear’s drainage (punctal plugs, cautery), and finally by settling down the ocular surface inflammation (steroids, cyclosporine, autologous serous), as appropriate. In this article we will review the clinical presentation, differential diagnosis, and treatment options for DED.

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“…Reduced tear meniscus lower than 0.2 mm is suggestive for diminished tear production, while increased height suggests obstruction to the nasolacrimal system (punctual obstruction, canalicular stenosis or nasolacrimal duct obstruction). 27,28 Also, the clinician could perform a dye disappearance test with a drop of 5 μl fluorescein placed in the inferior conjuctival fornix. The amount of fluorescein present in the tear lake is assessed after 5 minutes with a cobalt-blue light, and if most of the dye remains, the lacrimal system is unlikely to be functioning properly.…”

Section: Clinical Examinationmentioning

confidence: 99%

Dry Eye and Clinical Disease of Tear Film, Diagnosis and Management

Achtsidis¹,

Kozanidou²,

Bournas³

et al. 2014

European Ophthalmic Review

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Dry eye disease (DED) is a clinically significant multifactorial disorder of the ocular surface and tear film as it results in ocular discomfort and visual impairment and predisposes the cornea to infections. It is important for the quality of life and tends to be a chronic disease. It is also common, as the prevalence is estimated between 5 % to 30 % and this increases with age. Therefore, it is recognised as a growing public health problem that requires correct diagnosis and appropriate treatment. There are two main categories of DED: the deficiency of tear production (hyposecretive), which includes Sjögren syndrome, idiopathic or secondary to connective tissue diseases (e.g. rheumatoid arthritis), and non-Sjögren syndrome (e.g. age-related); and the tear evaporation category, where tears evaporate from the ocular surface too rapidly due to intrinsic causes (e.g. meibomian gland disease or eyelid aperture disorders) or extrinsic causes (e.g. vitamin A deficiency, contact lenses wear, ocular allergies). Management of the disease aims to enhance the corneal healing and reduce patient's discomfort. This is based on improving the balance of tear production and evaporation by increasing the tear film volume (lubrication drops) and improving quality of tear film (ex omega-3 supplements, lid hygiene, tetracyclines), reducing the tear film evaporation (paraffin ointments, therapeutic contact lenses), reducing tear's drainage (punctal plugs, cautery) and finally by settling down the ocular surface inflammation (steroids, cyclosporine, autologous serous), as appropriate. In this article we will review the clinical presentation, differential diagnosis and treatment options for DED. KeywordsDry eye disease, tear film, Sjögren, ocular inflammation. There is now an increased recognition by clinicians that dry eye disease (DED) is a common disorder characterised by dryness and damage of the ocular surface. It affects quality of life, including aspects of physical, social and psychological functioning, because it induces ocular discomfort, burning sensation, light sensitivity, visual disturbances or even corneal erosions and infections. DED is also known as keratoconjunctivitis sicca, dry eye syndrome and dysfunctional tear syndrome. DED prevalence has been reported to range from 5 % to 30 %, this being a likely result from differing study populations and DED definitions. In a large population study, Moss et al. reported the prevalence of dry eye to be 14.4 % in 3,722 subjects aged 48 to 91 years and noted that the prevalence of the condition doubled after the age of 59. As a consequence, DED prevalence is expected to increase in ageing populations, which will eventually make this health problem more prominent. [1][2][3][4] In order to address the problem, the International Dry Eye Workshop (DEWS) defines dry eye as a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance and tear film instability with potential damage to the ocular surface. It is accompanied ...

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Inverting Sutures for Tarsal Ectropion (The Leicester Modified Suture Technique)

Cited by 11 publications

References 8 publications

Tarsal Ectropion Repair With Modified Bick Eyelid Tightening and Inverting Sutures

Tarsal Ectropion Repair With Modified Bick Eyelid Tightening and Inverting Sutures

Dry Eye and Clinical Disease of Tear Film, Diagnosis and Management

Dry Eye and Clinical Disease of Tear Film, Diagnosis and Management

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