Purpose : To evaluate the effectiveness of eyelid retractor repair in cicatricial ectropion of the lower eyelid. Methods : The study design was a prospective case series. One hundred and twenty eight eyelids were operated on in 100 consecutive patients with cicatricial ectropion. All patients underwent lower eyelid retractor repair via a conjunctival approach combined with skin replacement to the anterior lamella with or without a horizontal lid tightening procedure. When only medial ectropion was present, a medial‐based transpositional skin flap was used to repair the anterior lamella (26 eyelids). The remaining eyelids with ectropion involving all or most of the eyelid underwent upper‐to‐lower eyelid lateral‐based transpositional skin flap repair (92 eyelids), or full thickness free skin grafting (10 eyelids). Horizontal lid tightening was performed by lateral canthoplasty in 123 eyelids. Results : Relief of cicatricial ectropion symptoms was reported in 90% of patients overall. A normal punctum position was achieved in 70% of eyelids, overall, and was highest (88%) with a medial‐based transpositional skin flap. Conclusions : Eyelid retractor repair combined with skin replacement and horizontal lid shortening is an effective procedure for cicatricial ectropion. 相似文献
Herein a modification of the highly useful lateral tarsal strip procedure is presented. The refinement of the technique uses an oblique, vertically orientated, asymmetric, periosteal transposition (OVAPT) flap from the lateral orbital rim to fix the tarsal strip. From a consecutive series of 53 patients, A cohort of 49 procedures on 41 patients with a minimum of 3-month follow up is described. The procedure had a high rate of success in terms of canthal fixation over the median 14-month follow up. There was only one case of late stretching of the canthal repair in an anophthalmic orbit, one case of recurrent cicatricial ectropion due to an inadequate skin graft, and finally a case of early recurrent tarsal ectropion. The OVAPT flap further enhances the stability of the tarsal strip procedure, and allows greater control of lid position and tension. The pull is in a superior and lateral direction, mimicking that of the lateral canthal tendon. 相似文献