Primary and secondary transconjunctival involutional entropion repair.

Mark Lucarelli // Publications // May 01 2001

PubMed ID: 11320033

Author(s): Cook T, Lucarelli MJ, Lemke BN, Dortzbach RK. Primary and secondary transconjunctival involutional entropion repair. Ophthalmology. 2001 May;108(5):989-93. PMID 11320033

Journal: Ophthalmology, Volume 108, Issue 5, May 2001

PURPOSE Lower eyelid involutional entropion is a significant disorder of the aging population resulting from horizontal eyelid laxity, overriding orbicularis oculi muscle, and attenuation of the lower eyelid retractors. The purpose of this study is to describe the long-term results of transconjunctival entropion repair.

DESIGN Interventional noncomparative case series.

PARTICIPANTS Thirty-six eyelids in 31 patients.

METHODS Charts were reviewed of all transconjunctival entropion repairs, which included myectomy, retractor fixation, and horizontal shortening performed by three oculoplastic surgeons between January 1993 and January 1999. Cases with less than 12 months follow-up were excluded.

MAIN OUTCOME MEASURES Entropion recurrence.

RESULTS Thirty-six lids in 31 patients were followed for mean of 31.5 months (12.5-79). Six of 36 lids (16.7%) had postoperative complications. Recurrent entropion occurred in 3 of 36 lids (8.3%) an average 16.3 months (7-35) after surgery. An average of 6 trichiasis lashes (1-10) occurred in 4 of 36 lids (11.1%) at a mean of 2.25 months (1-4) after surgery. There were no overcorrections. Three of 36 lids (8.3%) required additional surgery.

CONCLUSIONS Entropion recurrence after three-step transconjunctival repair is within the 0% to 30% reported recurrence for other repair techniques but more frequent than reported for a similar transcutaneous procedure. The 8.3% recurrence rate might have resulted from inadequate myectomy, inadequate retractor fixation, cicatricial changes directly related to the transconjunctival incision, or progressive involutional changes. Trichiasis was the most frequent complication. Transconjunctival entropion repair may be slightly less effective than transcutaneous repair.