Ectropion Repair
An ectropion is an outwardly turned (everted) eyelid. The
condition most often is associated with aging, though it may
also occur congenitally, as a result of scarring or other surgeries,
or secondary to facial nerve paralysis (Bell's Palsy). If not
repaired, the condition may lead to thickening of the mucosal
surface on the inside of the eyelid (conjunctiva) with consequent
inflammation of and danger to the health of the eye itself.
The best method of repair for an ectropion often depends on
the underlying cause. In the involutional type of ectropion
(associated with aging), most surgeons elect to shorten and
tighten the lower lid, thereby resolving the outwardly turned
lid. This typically is completed with an incision of the skin
at the lateral corner of the eye. The surgeon then excises
a small segment of the lateral aspect of the lower eyelid,
and subsequently reconnects the eyelid to underlying tissues
and the upper eyelid.
Usually only a few stitches are placed in the skin at the lateral
corner of the eye, and these are often removed 7 to 14 days
later. There is typically almost immediate resolution of the
condition. Most patients have little if any discomfort with
the procedure. There may be mild bruising and swelling following
the procedure. This should resolve within about two weeks.
Ectropion which occurs as a result of scarring (cicatricial
ectropion) is most likely to follow another surgical procedure
of the face or eyelids, especially excision of skin lesions
such as skin cancers. This type of ectropion repair often requires
skin grafting. The donor site for the skin graft is most often
taken from the patient’s upper eyelid or from behind the ear.
The skin from these sites will most closely match that of the
patient’s lower eyelid skin. Both the donor site for the graft
and the surgical site will usually heal nicely within two weeks
following the surgery.
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Entropion Repair
An entropion is an inwardly turned (inverted) eyelid. The condition
occurs primarily as a result of advancing age with consequent
weakening of certain eyelid muscles. The imbalance between eyelid
muscle groups results in the inward turning of the eyelid. The
condition almost always affects the lower, rather than the upper,
eyelids.
Repair of involutional entropion (associated with aging) may
be completed with a variety of procedures. Most cases are completed
with an incision in the lateral corner of the eye or an incision
just beneath the lower eyelashes. In either case, a tightening
of tissues is required to resolve the imbalance between the muscle
groups of the lower lid.
Most patients experience immediate resolution of the problem
once surgery is completed with little if any post-operative discomfort.
Most cases will require subsequent removal of sutures located
along the lower eyelashes or the lateral corner of the eyelid.
Minor bruising or swelling may be expected and will likely resolve
in one to two weeks following surgery.
A non-incisional entropion repair, known as a Quickert procedure,
may be completed as an in-office procedure. This form of entropion
repair requires two or three strategically placed sutures which
will evert the eyelid. The procedure can be completed under local
anesthesia with little if any discomfort.
The most important drawback of this procedure is that there is
a significantly higher chance of recurrence of the entropion
subsequently. The Quickert procedure, however, is an excellent
procedure for patients who do not desire, or are not good candidates
for, a trip to the operating room.
Make your appointment today.
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