Lower eyelid retractor (white-line) advancement to correct tarsal ectropion

Sagili, Suresh; Ha, Jerome

doi:10.1016/j.jcjo.2018.02.005

Cited by 6 publications

(9 citation statements)

References 13 publications

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“…We believe that postoperative scarring causes LERs to adhere to each other. In the LER advance for ectropion, past reports have raised concerns that excision of the conjunctiva may lead to a shallow fornix 1,8,9 . Still, in the present study, the fornix was not shallow and there were no problems with conjunctival healing (Fig.…”

Section: Discussioncontrasting

confidence: 48%

The ‘Invisible Lazy-T’ Procedure for Correction of Medial Ectropion

Uemura

Okuda

Ueno

et al. 2023

Journal of Craniofacial Surgery

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No accepted standard for the correction of medial ectropion has been established. The most critical part of the surgical treatment for medial ectropion is the tightening of both horizontal and vertical laxity. To correct this ectropion, we have applied a combination procedure which includes tightening of the conjunctiva and the eyelid retractors (posterior lamellae) and the lateral tarsal strip procedure. Our imitation of the 'Lazy-T', a surgical operation performed on the medial ectropion, is tentatively named 'Invisible Lazy-T'. It is a versatile technique with a less visible scar than alternative techniques because skin incision is made along the crease line of the 'the crow's feet'. Results suggest a satisfactory solution to this problem and with better outcomes than by other techniques. We propose this novel combination technique is the best strategy for the medial ectropion, and it does not require specialized surgical skill, so ectropion can be managed by craniofacial surgeons.

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Section: Discussioncontrasting

confidence: 48%

The ‘Invisible Lazy-T’ Procedure for Correction of Medial Ectropion

Uemura

Okuda

Ueno

et al. 2023

Journal of Craniofacial Surgery

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“…Sagili et al combined transconjunctival retractor advancement with a lateral tarsal strip in 25 eyelids in twenty patients. 11 The mean follow-up was 8.4 months, and successful outcomes were reported in all patients. 11…”

Section: Discussionmentioning

confidence: 88%

“…There have been various surgical correction methods proposed for tarsal ectropion. 1,3,4,[8][9][10][11] In many of these methods, a retractor reinsertion procedure was combined with a horizontal tightening procedure to achieve satisfactory results.…”

Section: Discussionmentioning

confidence: 99%

Tarsal Ectropion Repair With Modified Bick Eyelid Tightening and Inverting Sutures

Wang

Deng

Shinder

2022

Ophthalmic Plastic &Amp; Reconstructive Surgery

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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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“…Through this window, 6-0 vicryl sutures are used to reattach the lower lid retractor to the tarsal plate and conjunctiva [ 11 ]. Vertical lid tightening can also be achieved by reattachment or plication of the lower eyelid retractor to the inferior tarsal border via transconjunctival or transcutaneous approach [ 1 , 3 ]. A medial canthopexy with bone anchoring system could be another valid option [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…Involutional ectropion, the most frequent variant, is produced by age-related horizontal laxity of the orbicularis muscle and/or canthal tendons (medial and/or lateral). The disinsertion of the lower eyelid retractors may also play a role in some cases [ 3 ]. Paralytic ectropion can be developed after the loss of tone of the orbicularis oculi muscle (i.e., facial nerve paralysis, stroke, etc.).…”

Section: Introductionmentioning

confidence: 99%

Management of Severe Multifactorial Eyelid Ectropion With Lateral Tarsal Strip Procedure and Full-Thickness Skin Graft

Medina¹

2022

Cureus

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Secondary ectropion is a relatively common anatomo-functional abnormality of the lower eyelids. They can be seen in numerous clinical settings and generate disabling symptoms and even severe complications such as corneal ulceration, globe perforation, and blindness. Based on their etiology, cases of secondary ectropion are grouped into involutional, paralytic, cicatricial, and mechanical. Multiple techniques have been developed to treat specific abnormalities associated with this condition. Therefore, a comprehensive local assessment is crucial to select one or more surgical procedures for each particular situation. This report describes a patient with multiple contributing factors for severe ectropion of left lower eyelid treated with lateral tarsal strip procedure and full-thickness skin graft. Other surgical options and their indications are briefly reviewed.

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Lower eyelid retractor (white-line) advancement to correct tarsal ectropion

Cited by 6 publications

References 13 publications

The ‘Invisible Lazy-T’ Procedure for Correction of Medial Ectropion

The ‘Invisible Lazy-T’ Procedure for Correction of Medial Ectropion

Tarsal Ectropion Repair With Modified Bick Eyelid Tightening and Inverting Sutures

Management of Severe Multifactorial Eyelid Ectropion With Lateral Tarsal Strip Procedure and Full-Thickness Skin Graft

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