The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Isabel Elosua De Juan - One of the best experts on this subject based on the ideXlab platform.
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modified lateral tarsal strip for involutional entropion and Ectropion surgery
Graefes Archive for Clinical and Experimental Ophthalmology, 2017Co-Authors: Jose Santiago Lopezgarcia, Isabel Garcialozano, Carlos Gimenezvallejo, Belen Jimenez, Alvaro Sanchez, Isabel Elosua De JuanAbstract:Purpose Our purpose was to assess our outcomes in involutional lower eyelid Ectropion and entropion surgery after horizontal eyelid tightening by a modified tarsal strip technique.
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modified lateral tarsal strip for involutional entropion and Ectropion surgery
Graefes Archive for Clinical and Experimental Ophthalmology, 2017Co-Authors: Jose Santiago Lopezgarcia, Isabel Garcialozano, Carlos Gimenezvallejo, Belen Jimenez, Alvaro Sanchez, Isabel Elosua De JuanAbstract:Our purpose was to assess our outcomes in involutional lower eyelid Ectropion and entropion surgery after horizontal eyelid tightening by a modified tarsal strip technique. A prospective study of 88 eyelids with Ectropion and 96 with entropion was performed. Patients were randomly distributed into two groups: the control group included 90 eyelids (46 entropion and 44 Ectropion) and the other group of 94 eyelids (50 entropion and 44 Ectropion). The control group was treated with a conventional tarsal strip, whereas the second group underwent the same surgery except for a modified suture placement of the tarsal strip different in patients with Ectropion and entropion. The mean follow-up was 5.4 years. Horizontal eyelid laxity, orbicularis muscle and lower eyelid retractors function were measured prior and after surgery. Recurrence rate was also evaluated. Recurrent entropion occurred in eight eyelids (17.4 %) treated with conventional tarsal strip, while only two eyelids (4 %) showed recurrence after surgery in the group treated with the modified technique. Recurrence Ectropion was only found in one eyelid (2.3 %) in the control group. Pathological horizontal laxity was present in all patients at the baseline study. After surgery, the horizontal laxity improved in both groups, we found significant differences in the patients treated with the modified technique (P=0.04). The modified suture placement of the tarsal strip reported in this work improves the lower eyelid stability and prevents future recurrences after surgery. This modified technique is useful for the management of patients with entropion and moderate eyelid dysfunction retractors without other surgical procedures.
Hee Joon Kim - One of the best experts on this subject based on the ideXlab platform.
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viability of full thickness skin grafts used for correction of cicatricial Ectropion of lower eyelid in previously irradiated field in the periocular region
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2013Co-Authors: Hee Joon Kim, Brent Hayek, Qasiem J Nasser, Bita EsmaeliAbstract:Background. The purpose of this study was to evaluate the viability of skin grafts used for correction of cicatricial Ectropion resulting from previous ablative surgery and radiotherapy for head and neck cancer and to report overall outcomes of cicatricial Ectropion repair. Methods. This is a retrospective, noncomparative case series of all consecutive patients with head and neck cancer who had been exposed to high-dose radiation therapy in their periocular region and had surgical correction of their lower eyelid cicatricial Ectropion through placement of a full-thickness skin graft and a lower eyelid tightening procedure by the same surgeon. The primary outcome measure was skin graft viability. Secondary outcome measures comprised postoperative complications, the overall outcome of Ectropion repair as judged by improvement in symptoms of exposure keratopathy, and dependence on lubricating eye drops and ointments, as well as cosmetic improvement measured through a grading scale based on the degree of inferior scleral show and/or tarsal conjunctival eversion. Results. Twenty-five patients were eligible for the study. Nineteen men and 6 women had a median age of 63 years (range, 20-84 years). All 25 patients had high-dose radiation therapy for their head and neck cancer. All but 1 patient had major cancer ablative surgery performed before radiation therapy. Thirteen of 25 patients also received chemotherapy. There was 100% viability of the skin grafts used for the repair of lower eyelid cicatricial Ectropion. There were a few postoperative complications including the need for revision surgery to correct residual Ectropion in the lower eyelid in 2 patients, and a third patient required a revision surgery due to upper eyelid retraction and lagophthalmos after harvest of skin graft from the upper eyelid. Improvement was noted in the subjective symptoms in 22 of 25 patients (88%), whereas 17 patients (68%) were noted to have improvement in their clinical findings on slit lamp examination. All 20 patients, for whom good quality photos were available, had improvement in the degree of cicatricial lower eyelid Ectropion as measured by the amount of inferior scleral show and tarsal conjunctival eversion, although 11 patients had some residual Ectropion. All 20 had either good or excellent results in the appearance of their skin grafts. Conclusion. Our findings suggest that full-thickness skin grafts are a nice option for correction of cicatricial lower eyelid Ectropion in a previously radiated field; 100% of the grafts survived. The majority of patients had improvement of ocular surface damage and symptoms, with a decreased dependence on topical lubricants. All evaluable patients had improvement in the degree of cicatricial lower eyelid Ectropion, although close to one-half of patients had some mild residual Ectropion. The majority of patients had excellent appearance of the skin graft. V C 2012 Wiley Periodicals, Inc. Head Neck 35: 103-108, 2013
James Mckelvie - One of the best experts on this subject based on the ideXlab platform.
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cicatricial Ectropion surgery a prospective study of long term symptom control patient satisfaction and anatomical success
Clinical and Experimental Ophthalmology, 2018Co-Authors: James Mckelvie, Taras Papchenko, Stuart C CarrollAbstract:IMPORTANCE Cicatricial Ectropion repair is effective and has a low complication rate. BACKGROUND To evaluate the effectiveness and long-term functional outcomes of surgical repair of lower lid cicatricial Ectropion. DESIGN Prospective consecutive case series. PARTICIPANTS Forty-four consecutive operations for cicatricial Ectropion repair. METHODS Consecutive cases of cicatricial Ectropion repair completed during 2007-2011 in Waikato Hospital and Hamilton Eye Clinic, New Zealand, were enrolled in the study following formal ethics approval. Ectropion repair was completed using inferior retractor repositioning, horizontal lid tightening and full-thickness skin grafting. MAIN OUTCOME MEASURES Patient-reported symptoms and satisfaction, Ectropion recurrence and punctal Ectropion. RESULTS Forty-four eyes of 40 patients (30 males and 10 female) were included in the study. The average age at surgery was 75 years. Watering and poor appearance were the most common presenting symptoms. Postoperative follow-up was 1-6 years (mean = 4 years). There were no major perioperative complications, one patient developed trichiasis postoperatively. There were five reoperations (11%) during the study period. Two patients underwent medial spindle procedures for symptomatic medial Ectropion and three patients required additional horizontal lid tightening. Seventy percent of patients reported satisfaction with their long-term results despite the partial recurrence of symptoms in 45%. Ectropion recurrence in <1 year occurred in three patients. CONCLUSION AND RELEVANCE In this series, satisfactory appearance and symptom control were reported by 68% of patients at long-term follow-up. Preoperative marked Ectropion with marked lid laxity is associated with early treatment failure and may be regarded as a relative contraindication to surgical correction with this technique. Punctal Ectropion is an unreliable indicator of functional success.
Dinesh Selva - One of the best experts on this subject based on the ideXlab platform.
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upper eyelid anatomy an update
Annals of Plastic Surgery, 2009Co-Authors: Raman Malhotra, Dinesh SelvaAbstract:The gross anatomy of the lower eyelid is analogous to that of the upper eyelid, however, the lower eyelid has a more simplified structure with less dynamic movement. Common malpositions of the lower eyelid include entropion and Ectropion, rehabilitative surgery of which requires a thorough understanding of lower eyelid anatomy. Furthermore, precise anatomic knowledge is a prerequisite for both reconstructive and cosmetic lower eyelid surgery in order for it to be performed appropriately. In this review, we present the clinical anatomy of the structures of the lower eyelid, as well as highlighting relevant surgical implications. Featured here are the structure of the different eyelid lamellae, the lower eyelid retractors and their relations, the orbital septum, fat pad compartments, and Lockwood ligament.
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the use of a polyglactin suture in the lateral tarsal strip procedure
American Journal of Ophthalmology, 2004Co-Authors: James Hsua, Dinesh SelvaAbstract:Purpose To evaluate the rate of recurrence of horizontal laxity or lid malposition and suture-related complications associated with the use of an absorbable suture in the lateral tarsal strip procedure. Design Prospective, interventional, consecutive case series. Methods A prospective study. setting: Institutional. patient population: One hundred patients with horizontal lid laxity associated with Ectropion or entropion. Patients with paralytic Ectropion or ocular prostheses were excluded. intervention: One hundred and five lateral tarsal strip procedures were performed using a 6-0 polyglactin suture. These were combined with full-thickness skin grafts (34), internal (55) or external (23) retractor plications, and inverting sutures (4) as required to correct the lid malposition. main outcome measures: Recurrence of horizontal laxity or lid malposition and suture related complications were the main outcome measures. Suture related wound infection was diagnosed clinically by the presence of pus associated with wound breakdown. Results One patient failed to reach 3-month follow-up and was excluded. There was one recurrence of horizontal laxity after a mean follow-up period of 9.1 months. Four patients developed lateral canthal wound infections, compared with none at the other operative sites. The 95% confidence intervals for infections in the tarsal strip procedure were 1.1% to 9.6%, which were significantly greater than zero ( P Conclusion A 6-0 absorbable suture may be used for the lateral tarsal strip and does not lead to a recurrence of horizontal laxity. It does not appear to reduce the wound infection rate associated with this procedure.
Jose Santiago Lopezgarcia - One of the best experts on this subject based on the ideXlab platform.
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modified lateral tarsal strip for involutional entropion and Ectropion surgery
Graefes Archive for Clinical and Experimental Ophthalmology, 2017Co-Authors: Jose Santiago Lopezgarcia, Isabel Garcialozano, Carlos Gimenezvallejo, Belen Jimenez, Alvaro Sanchez, Isabel Elosua De JuanAbstract:Purpose Our purpose was to assess our outcomes in involutional lower eyelid Ectropion and entropion surgery after horizontal eyelid tightening by a modified tarsal strip technique.
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modified lateral tarsal strip for involutional entropion and Ectropion surgery
Graefes Archive for Clinical and Experimental Ophthalmology, 2017Co-Authors: Jose Santiago Lopezgarcia, Isabel Garcialozano, Carlos Gimenezvallejo, Belen Jimenez, Alvaro Sanchez, Isabel Elosua De JuanAbstract:Our purpose was to assess our outcomes in involutional lower eyelid Ectropion and entropion surgery after horizontal eyelid tightening by a modified tarsal strip technique. A prospective study of 88 eyelids with Ectropion and 96 with entropion was performed. Patients were randomly distributed into two groups: the control group included 90 eyelids (46 entropion and 44 Ectropion) and the other group of 94 eyelids (50 entropion and 44 Ectropion). The control group was treated with a conventional tarsal strip, whereas the second group underwent the same surgery except for a modified suture placement of the tarsal strip different in patients with Ectropion and entropion. The mean follow-up was 5.4 years. Horizontal eyelid laxity, orbicularis muscle and lower eyelid retractors function were measured prior and after surgery. Recurrence rate was also evaluated. Recurrent entropion occurred in eight eyelids (17.4 %) treated with conventional tarsal strip, while only two eyelids (4 %) showed recurrence after surgery in the group treated with the modified technique. Recurrence Ectropion was only found in one eyelid (2.3 %) in the control group. Pathological horizontal laxity was present in all patients at the baseline study. After surgery, the horizontal laxity improved in both groups, we found significant differences in the patients treated with the modified technique (P=0.04). The modified suture placement of the tarsal strip reported in this work improves the lower eyelid stability and prevents future recurrences after surgery. This modified technique is useful for the management of patients with entropion and moderate eyelid dysfunction retractors without other surgical procedures.
