Programm                 "Degeneration und Regeneration– Grundlagen, Diagnostik und Therapie"

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Combined Surgical Procedure for the Treatment of Involutional Entropion and Ectropion of the Lower Lid

Emesz M., Wohlfart C., Zschock W., Grabner G.
Regional Clinic for Ophthalmology and Optometry, St. Johann's Hospital, Regional Clinical Centre, Salzburg, Austria

Purpose: Fifty patients with involutional entropion and 25 patients with ectropion without laxity of the medial canthal tendon were treated with a combined surgical procedure at the Landesaugenklinik Salzburg. Under local anesthesia the lower limb of the lateral canthal tendon was cut. The horizontal lid laxity was corrected with a lateral tarsal sling. For the entropion we combined this procedure with a full thickness horizontal transverse incision and everting sutures (Wies' procedure). For the ectropion an excision of a horizontal "diamond" of tarsoconjunctiva was added medially to invert the punctum.
Method: A horizontal laxity of the lower lid is the main cause for entropion and ectropion. Both, a relaxed temporal canthal tendon, as well as the involutional changes of the tarsal plate and the lower lid retractors are responsible for the instability of the lid. Whenever the preseptal part of the orbicularis muscle slides over the pretarsal part an entropion will result, in cases with no hypertrophia of this muscle the laxity of the lower lid retractors will cause an ectropion. The aim of this study was to develop quick and potentially repeatable, combined procedures in order to lower the recurrence rate.
Results: All 75 patients could be discharged with adequate position of the lower lid one da

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