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Category: Volume 08 Issue 07 July 2020
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Title: Management of Ectropion with Medial Canthal Tendon Laxity

Author: Dr Ali Al-Ammouri, MD, PhD

 DOI: https://dx.doi.org/10.18535/jmscr/v8i7.01

Abstract

Objective: Ectropion is usually associated with laxity of the medial and lateral aspects of the lower eyelid. The goal of this study is to outline management and surgical correction of ectropion accompanied by variable degrees of eyelid laxity.

Patients and Methods: A retrospective study of 15 patients with ectropion along with different degrees of medial canthal ligament laxity were managed according to the ectropion grades, classification and surgical approach were described in this study. Patients were followed up for 3, 6 and 12 months postoperatively.

Results: Tight fixation of medial eyelid opposed to lateral traction and correction of ectropion were accomplished in all cases. Aesthetic outcome was achieved in 12 cases, while epiphora was treated in 14 cases.

Conclusion: Surgical repair for ectropion should be directed according to the clinical findings which renders the outcome to be favourable.

Keywords: Ectropion, Lid Tightening, Medial Canthus, Lower Lid.

References

  1. Jordan DR, Anderson RL. The lateral tarsal strip revisited: the enhanced tarsal strip. Arch Ophthalmol 1989; 107:604–606.
  2. Olver JM. Surgical tips on the lateral tarsal strip. Eye 1998; 12:1007–1012.
  3. Collin JR. A manual of systematic eyelid surgery. 2nd ed. London, UK: Churchil Livingstone; 1989. 27–39.
  4. O’Donell BA, Anderson RL, Collin JR, Fante RG, Jordan DR, Retling P. Repair of the medial canthal tendon. Br J Ophthalmol 2003; 87:220–224.
  5. Olver JM, Sathia PJ, Wright M. Lower eyelid medial canthal tendon laxity grading. An interobserver study of normal subjects. Ophthalmology 2001; 108:2321–2325.
  6. Frueh BR, Schoengarth LD. Evaluation and treatment of the patient with ectropion. Am J Ophthalmol 1982; 89:1049–1054.
  7. Tse DT. Surgical correction of punctual malposition. Am J Ophthalmol 1985; 339–340.
  8. Smith B. The lazy-T correction of ectropion of the lower punctum. Arch Ophthalmol 1976; 94:1149–1150.
  9. Hurwitz JJ, Tucker S. Posterior horizontal and vertical tightening to treat combined punctal ectropion with medial canthal tendon laxity. Ophthal Surg 1990; 21:721–725.
  10. Franzco IC, Franzco GA, Sharma S, Franzco MT. Transcaruncular medial orbitotomy for stabilization of the posterior limb of the medial canthal tendon. Clin Experiment Ophthalmol 2001; 29:85–89.
  11. Edelstein JP, Dryden RM. Medial palpebral tendon repair for medial ectropion of the lower eyelid. Ophthal Plast Reconstr Surg 1990; 628–3.
  12. Crawford J, Collin JR, Moriarty PA. The correction of paralytic medial ectropion. Br J Ophthalmol 1984; 68:639–641.
  13. Sullivan TJ, Collin JR. Medial canthal resection: an effective long-term cure for medial ectropion. Br J Ophthalmol 1991; 75:288–291.
  14. McCord CD, Nunery WR. Reconstruction of the lower eyelid and outer canthus. In: McCord CD, Tanenbaum M. Oculoplastic surgery. New York: Raqven Press; 1987. 107–109.
  15. Jordan DR, Anderson RL, Thiese SN. The medial tarsal strip. Arch Ophthalmol 1990; 108:120–124.
  16. Goldberg RA. Oculoplastic surgeons think mechanically. Arch Ophthalmol 2001; 119:756–757.
  17. Anderson RL, Gordy DD. The tarsal strip procedure. Arch Ophthalmol 1979; 97:2192–2196.
  18. Nowiniski TS, Anderson RL. The medial spindle procedure for involutional medial ectropion. Arch Ophthalmol 1985; 103: 1750–1753.

Corresponding Author

Dr Ali Al-Ammouri, MD, PhD

Ophthalmology Department

Hussein Hospital-Ministry of Health

Al Salt-Jordan