CC BY-NC 4.0 · Arch Plast Surg 2018; 45(06): 525-533
DOI: 10.5999/aps.2018.00836
Original Article

Algorithm for the management of ectropion through medial and lateral canthopexy

Siook Baek
Department of Plastic and Reconstructive Surgery, Korea University College of Medicine, Seoul, Korea
,
Jae-Ho Chung
Department of Plastic and Reconstructive Surgery, Korea University College of Medicine, Seoul, Korea
,
Eul-Sik Yoon
Department of Plastic and Reconstructive Surgery, Korea University College of Medicine, Seoul, Korea
,
Byung-Il Lee
Department of Plastic and Reconstructive Surgery, Korea University College of Medicine, Seoul, Korea
,
Seung-Ha Park
Department of Plastic and Reconstructive Surgery, Korea University College of Medicine, Seoul, Korea
› Author Affiliations

Background Patients with ectropion experience devastating symptoms. Therefore, the preventionand management of this condition are of utmost importance. To treat ectropion, it is important to perform medial and lateral canthopexy in an effective way. In this study, we propose a comprehensive algorithm for the prevention and management of ectropion based on a new classification of ectropion according to its signs and causes.

Methods Canthopexy was performed in 68 cases according to the proposed algorithm, which starts with a categorization of the types of ectropion and ends with the recommended operative technique. To assess the results, we reviewed clinical preoperative and postoperative photographs. To evaluate improvements in patients’ symptoms, we conducted a survey with responses scored on a Likert scale.

Results None of the patients had scleral show postoperatively. The average patient satisfaction score was satisfied or higher for all symptoms, and the most improved symptom was aesthetic appearance. No major complications were reported.

Conclusions For the comprehensive management of ectropion, it is crucial to consider both treatment and prevention. Through the simple surgical algorithm proposed in this study, both medically acceptable results and high levels of patient satisfaction were achieved without significant postoperative complications. We recommend using this algorithm for the comprehensive management of ectropion.



Publication History

Received: 29 June 2018

Accepted: 18 October 2018

Article published online:
03 April 2022

© 2018. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • REFERENCES

  • 1 Bedran EG, Pereira MV, Bernardes TF. Ectropion. Semin Ophthalmol 2010; 25: 59-65
  • 2 Bergeron CM, Moe KS. The evaluation and treatment of lower eyelid paralysis. Facial Plast Surg 2008; 24: 231-41
  • 3 Vallabhanath P, Carter SR. Ectropion and entropion. Curr Opin Ophthalmol 2000; 11: 345-51
  • 4 Georgescu D. Surgical preferences for lateral canthoplasty and canthopexy. Curr Opin Ophthalmol 2014; 25: 449-54
  • 5 Azuma R, Aoki S, Aizawa T. et al. The vertical orbicularis oculi muscle turn-over procedure for the correction of paralytic ectropion of the lower eyelid. Arch Plast Surg 2018; 45: 135-9
  • 6 McCord CD, Boswell CB, Hester TR. Lateral canthal anchoring. Plast Reconstr Surg 2003; 112: 222-37
  • 7 Pepper JP, Kim JC, Massry GG. A surgical algorithm for lower eyelid resuspension in facial nerve paralysis. Oper Tech Otolayngol Head Neck Surg 2012; 23: 248-52
  • 8 Fagien S. Algorithm for canthoplasty: the lateral retinacular suspension: a simplified suture canthopexy. Plast Reconstr Surg 1999; 103: 2042-53
  • 9 Trussler AP, Rohrich RJ. MOC-PSSM CME article: blepharoplasty. Plast Reconstr Surg 2008; 121 1 Suppl 1-10
  • 10 Jacobs SW. Prophylactic lateral canthopexy in lower blepharoplasties. Arch Facial Plast Surg 2003; 5: 267-71
  • 11 Anderson RL, Gordy DD. The tarsal strip procedure. Arch Ophthalmol 1979; 97: 2192-6
  • 12 Jordan DR, Anderson RL. The lateral tarsal strip revisited: the enhanced tarsal strip. Arch Ophthalmol 1989; 107: 604-6
  • 13 Olver JM. Surgical tips on the lateral tarsal strip. Eye (Lond) 1998; 12(Pt 6): 1007-12
  • 14 Antonyshyn OM, Weinberg MJ, Dagum AB. Use of a new anchoring device for tendon reinsertion in medial canthopexy. Plast Reconstr Surg 1996; 98: 520-3
  • 15 Hayashi A, Maruyama Y, Okada E. et al. Use of a suture anchor for correction of ectropion in facial paralysis. Plast Reconstr Surg 2005; 115: 234-9
  • 16 Alfano C, Chiummariello S, Monarca C. et al. Lateral canthoplasty by the Micro-Mitek Anchor System: 10-year review of 96 patients. J Oral Maxillofac Surg 2011; 69: 1745-9
  • 17 Bartsich S, Swartz KA, Spinelli HM. Lateral canthoplasty using the Mitek anchor system. Aesthetic Plast Surg 2012; 36: 3-7