Modified tarsotomy for the treatment of severe cicatricial entropion

Chi, Mijung; Kim, H J; Vagefi, R; Kersten, Robert C.

doi:10.1038/eye.2016.77

Cited by 14 publications

(6 citation statements)

References 18 publications

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“…This is often caused by conjunctival scarring following excision and repair of lower eyelid defects without addressing the posterior lamellar component. Patients with predisposing conditions such as chronic blepharoconjunctivitis or long-time glaucoma topical therapy users 8 are at a higher risk of inflammatory changes that result in fibrosis, mucosal scarring, and subsequent lid malposition. Stevens-Johnson's syndrome, ocular cicatricial pemphigoid, and other cicatrizing conjunctival disorders often lead to cicatricial entropion and trichiasis independent of any cancer surgery, which can only worsen a challenging situation.…”

Section: Cicatricial Entropionmentioning

confidence: 99%

“…Once the surgeon determines that reconstructive surgery is required, the goal should be complete release of the scar tissue and elimination of any vertical tension followed by reconstruction of the resulting defect "from scratch." 8,40,41 Any laxity should be addressed at this time, and any grafts or flaps should be significantly oversized (►Fig. 6).…”

Section: Managing Complicationsmentioning

confidence: 99%

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Eyelid Complications Associated with Surgery for Periocular Cutaneous Malignancies

2020

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Periocular skin is highly prone to malignancies, especially basal cell and squamous cell carcinomas. Because of the complex anatomy and eye-protecting functions of the periocular tissues, treatment of these cancers requires special considerations. Mohs micrographic surgery is usually the treatment of choice, whenever possible, in order to enhance margin control while limiting collateral damage to nearby normal structures. Cancer excision, whether by Mohs or other techniques, will leave a complex defect that requires careful anatomical and functional reconstruction. This study presents some of the challenges of treating periocular skin cancer and associated reconstructive surgery and provides an intellectual framework for addressing these challenges. The key topics are adherence to anatomical landmarks and aesthetic units, proper distribution of tension, and matching the correct reconstructive approach, that is, type of flap or graft, to the defect at hand. This review is not meant to be exhaustive, but it will provide both basic and advanced considerations.

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Section: Cicatricial Entropionmentioning

confidence: 99%

Section: Managing Complicationsmentioning

confidence: 99%

Eyelid Complications Associated with Surgery for Periocular Cutaneous Malignancies

2020

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“…; Erdogan & Ugurlu ; Chi et al. ). Slight overcorrection is initially aimed for due to the tendency for cicatricial contracture and inward rotation within the first 3 months of surgery (Kersten et al.…”

Section: Discussionmentioning

confidence: 99%

Meibomian gland inversion: under‐recognized entity

Siah

Boboridis

Tan

et al. 2019

Acta Ophthalmologica

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Objective: To describe a clinical entity of upper eyelid margin and meibomian gland inversion (MGI) sequential to meibomian gland dysfunction (MGD), in the absence of eyelash ptosis, trichiasis or manifest marginal entropion. We highlight its clinical features, surgical management and outcomes. Methods: We performed a retrospective analysis of symptomatic MGI cases refractory to conservative management who underwent surgery in our centre over a 4-year period. Anatomical correction, resolution of symptoms and possible complications are reported. Results: A total of 21 eyelids of 13 patients (mean age: 68.5 AE 15.4, range: 32-88 years) were analysed. Symptomatic MGI patients were operated only if they have noted immediate comfort when we corrected the lid margin position with a cotton tip. Those with refractory superior punctate corneal staining (n = 14 eyes), blink-related discomfort (n = 8) and pseudo-blepharospasm (n = 3) reported complete postoperative resolution. Milder symptoms showed partial improvement: gritty feeling (79%), sore eye (80%) and watery eye (86%). However, symptoms of dry eye disease (DED) persisted in 88% of patients. One case recurred in 6 weeks and was offered revision surgery. Median follow-up was 5 (range: 3-12) months. Conclusion: Meibomian gland inversion (MGI) is a subtle clinical entity that can be easily overlooked. Symptoms are often attributed to DED or MGD alone. It is likely that MGI represents early upper lid margin anatomical changes secondary to MGD before cicatricial marginal entropion becomes clinically apparent. Recommended treatment is conservative with intensive lid hygiene and topical MGD management. However, refractory symptomatic cases who respond positively to a 'cotton-tip test' (reversal of lid margin malposition with a rolling cotton-tip) may benefit from surgical intervention with favourable anatomical and functional outcome.

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“…The tarsotomy procedure is a conventional and classic surgery to treat trachoma-induced UCE in Asian countries (13)(14)(15). In that surgery, a horizontal tarsotomy is formed across the entire tarsus, and then the anterior lamella and lid margin is rotated with external sutures.…”

Section: Discussionmentioning

confidence: 99%

The upper eyelid levator weakening procedure for the correction of severe cicatricial entropion caused by trachoma

et al. 2020

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Background: Trachoma-induced upper eyelid cicatricial entropion (UCE) is a common and challenging eyelid disease. Surgeons have developed various surgical techniques to address UCE in the world.However, there are few reports about surgery for Chinese patients. Our study aims to evaluate the esthetic and functional outcomes of correction of trachoma-induced UCE using upper eyelid levator weakening combined with tarsotomy and an anterior lamella recession procedure in China.

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Modified tarsotomy for the treatment of severe cicatricial entropion

Cited by 14 publications

References 18 publications

Eyelid Complications Associated with Surgery for Periocular Cutaneous Malignancies

Eyelid Complications Associated with Surgery for Periocular Cutaneous Malignancies

Meibomian gland inversion: under‐recognized entity

The upper eyelid levator weakening procedure for the correction of severe cicatricial entropion caused by trachoma

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