Document Detail

A useful augmented lateral tarsal strip tarsorrhaphy for paralytic ectropion.
MedLine Citation:
PMID:  16343628     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Patients with paralytic ectropion and lagophthalmos may experience keratitis and may pose a functional and aesthetic surgical challenge. Various methods are used to reduce the vertical palpebral aperture, including lateral tarsal strip (LTS) or a lateral tarsorrhaphy. We modified the LTS to differentially shorten and elevate the lower lid more than the upper: an augmented LTS tarsorrhaphy (aug-LTS-T). This study aimed to evaluate the technique. DESIGN: Prospective noncomparative surgical trial in which preoperative and postoperative symptoms, margin reflex distances, vertical palpebral aperture (PA), lagophthalmos, and corneal findings were recorded. The data were analyzed at 6 months after surgery using the Wilcoxon sign-rank test for nonparametric data. PARTICIPANTS: Fourteen consecutive adult patients (15 eyelids) with chronic lagophthalmos and paralytic ectropion. METHODS: Patients underwent aug-LTS-T. This consisted of a long strip (10-15 mm) that is attached to the outer temporal orbital rim, at a point higher than a conventional LTS. It included removal of a small part of the upper eyelid anterior lamella laterally to pass the long strip up high enough. MAIN OUTCOME MEASURES: Improvement of symptoms, reduction of lower margin reflex distance, lagophthalmos, and improvement of corneal signs. RESULTS: Minimum follow-up was 6 months. There was a significant reduction in PA (P = 0.005) and lagophthalmos (P = 0.0002) with improvement of corneal signs (14 of 15 eyelids = 93%). Surgery was successful anatomically in 14 of 15 eyelids (93%) with low morbidity. CONCLUSIONS: We describe the augmented LTS tarsorrhaphy and find it effective in the treatment of severe lower eyelid ectropion resulting from facial palsy.
Lydia Chang; Jane Olver
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Publication Detail:
Type:  Journal Article     Date:  2005-12-15
Journal Detail:
Title:  Ophthalmology     Volume:  113     ISSN:  1549-4713     ISO Abbreviation:  Ophthalmology     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-03     Completed Date:  2006-01-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802443     Medline TA:  Ophthalmology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  84-91     Citation Subset:  IM    
Oculoplastic and Orbital Service, Western Eye Hospital, St. Mary's National Health Service Trust, London, United Kingdom.
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MeSH Terms
Aged, 80 and over
Ectropion / etiology,  surgery*
Eyelids / surgery*
Facial Paralysis / complications*
Follow-Up Studies
Keratitis / prevention & control
Middle Aged
Ophthalmologic Surgical Procedures*
Prospective Studies
Suture Techniques

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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