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Involutional Ectropion Repair

  • David T. Tse
Chapter

Abstract

Ectropion is a commonly encountered eyelid malposition characterized by eversion of the eyelid margin away from the globe. Although the upper or lower eyelid may be affected, this condition more commonly involves the lower eyelid. Chronic exposure of the globe and palpebral conjunctiva results in dry eye symptoms with reflex tearing. The exposed palpebral conjunctiva becomes inflamed and may develop metaplastic changes of epidermalization. An exposed punctum can become stenotic, contributing to tear outflow impairment. Additionally, corneal exposure may lead to epithelial breakdown, with increased risk of infectious keratitis. Upper eyelid ectropion often results from cicatricial changes of the anterior lamella related to previous injury, such as laceration or burn. Iatrogenic upper eyelid ectropion may occasionally occur after ptosis repair or blepharoplasty.

Keywords

Ectropion Repair Horizontal lid laxity Lateral tarsal strip Punctal malposition Medial spindle Medial canthal tendon laxity Medical canthal tendon plication Vertical skin tightness Orbicularis paresis Seventh nerve palsy Lower eyelid retractor disinsertion Suture inversion 

Supplementary material

419986_5_En_26_MOESM1_ESM.mp4 (110.5 mb)
Video 26.1 Lateral tarsal strip. Courtesy of Richard C. Allen, MD, PhD, FACS. http://webeye.ophth.uiowa.edu/eyeforum/video/plastics/1/lateral-tarsal-strip.htm (MP4 113110 kb)
419986_5_En_26_MOESM2_ESM.mp4 (143.8 mb)
Video 26.2 Medial spindle with lateral tarsal strip for repair of ectropion. Courtesy of Richard C. Allen, MD, PhD, FACS. http://webeye.ophth.uiowa.edu/eyeforum/video/plastics/1/Medial-spindle-lateral-tarsal-strip-repair-ectropion.htm (MP4 147219 kb)
419986_5_En_26_MOESM3_ESM.mp4 (133.2 mb)
Video 26.3 Transconjunctival retractor reinsertion with lateral tarsal strip for the treatment of involutional ectropion. Courtesy of Richard C. Allen, MD, PhD, FACS. http://webeye.ophth.uiowa.edu/eyeforum/video/plastics/1/Transconjunctival-ectropion.htm (MP4 136363 kb)
419986_5_En_26_MOESM4_ESM.mp4 (140.8 mb)
Video 26.4 Inverting sutures with upper canthoplasty and lateral tarsal strip. Courtesy of Richard C. Allen, MD, PhD, FACS. http://webeye.ophth.uiowa.edu/eyeforum/video/plastics/2/LTS-inverting-suture.htm (MP4 144210 kb)

References

  1. 1.
    Frueh BR, Schoengarth LD. Evaluation and treatment of the patient with ectropion. Ophthalmology. 1982;89(9):1049–54.CrossRefPubMedGoogle Scholar
  2. 2.
    Anderson RL, Gordy DD. The tarsal strip procedure. Arch Ophthalmol. 1979;97(11):2192–6.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Professor of Ophthalmology, Dermatology, Otolaryngology, and NeurosurgeryBascom Palmer Eye Institute, University of Miami Miller School of MedicineMiamiUSA

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