The versatile lid crease approach to upper eyelid margin rotation

Antonio A.V. Cruz, Patricia M.S. Akaishi, Mohammed Al-Dufaileej, Alicia Galindo-Ferreiro

Research output: Contribution to journalArticlepeer-review

Abstract

Lid margin rotational procedures have been used to correct cicatricial trachomatous entropion since the 19th century. There are two basic types of surgeries used for lid margin rotation. The first type is based on through-and-through approach combining tarsotomy and the use of sutures on the anterior lamella. The second type of surgery was suggested by Trabut, who proposed a tarsal advancement by posterior approach. We demonstrate that using a lid crease incision combines the basic mechanisms of the anterior and posterior approaches and in addition, addresses a variety of lid problems commonly found in the aged population with cicatricial entropion. After tarsal plate exposure, a tarsotomy through conjunctiva is performed as described by Trabut. Then, instead of using external sutures secured by bolsters, internal absorbable sutures can be used to simultaneously advance the distal tarsal fragment and exert strong tension on the marginal orbicularis muscle. Sixty lids of 40 patients underwent surgery with a lid crease incision. The follow-up ranged from 1 to 12 months (mean 3.0 months ± 2.71). Forty percent of the patients (24 lids) had more than 3 months of follow-up. Adequate margin rotation was achieved in all lids but one that showed a medial eyelash touching the cornea.

Original languageEnglish (US)
Pages (from-to)407-409
Number of pages3
JournalMiddle East African Journal of Ophthalmology
Volume22
Issue number4
DOIs
StatePublished - Oct 1 2015

Keywords

  • Cicatricial Entropion
  • Lid Crease
  • Lid Margin Rotation
  • Trachoma

ASJC Scopus subject areas

  • Ophthalmology

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