May 2003
Volume 44, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2003
Involutional Ectropion of the Lower Eyelid and Gender
Author Affiliations & Notes
  • D.C. Garibaldi
    Wilmer Eye Institute, Johns Hopkins Univ Sch of Med, Baltimore, MD, United States
  • S.L. Merbs
    Wilmer Eye Institute, Johns Hopkins Univ Sch of Med, Baltimore, MD, United States
  • M.P. Grant
    Wilmer Eye Institute, Johns Hopkins Univ Sch of Med, Baltimore, MD, United States
  • N.T. Iliff
    Wilmer Eye Institute, Johns Hopkins Univ Sch of Med, Baltimore, MD, United States
  • Footnotes
    Commercial Relationships  D.C. Garibaldi, None; S.L. Merbs, None; M.P. Grant, None; N.T. Iliff, None.
Investigative Ophthalmology & Visual Science May 2003, Vol.44, 2424. doi:
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      D.C. Garibaldi, S.L. Merbs, M.P. Grant, N.T. Iliff; Involutional Ectropion of the Lower Eyelid and Gender . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2424.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Abstract: : Purpose: To examine whether there is a gender association with involutional ectropion of the lower eyelid. Methods: This is a retrospective review of all cases of surgically repaired involutional ectropion performed by the oculoplastics attendings (NTI and SLM) at the Wilmer Eye Institute from Nov. 1999 through Nov. 2002. Cases were selected from a database using the CPT codes for ectropion repair and all available charts were reviewed. Involutional ectropion was defined as symptomatic eversion and/or laxity of the lower eyelid. Those patients with prior lid surgery, trauma, enucleation, upper eyelid ectropion, and paralytic ectropion were excluded and the remaining subgroup was subjected to analysis. Results: 80 patients had ectropion repair over the study period. Of these, 75 charts were available for review (93.8%). 58 (77.3%) were excluded according to the following criteria: prior surgery - 31 (41.3%); prior trauma/scarring - 10 (13.3%); post-enucleation - 7 (9.3%); paralytic ectropion - 5 (6.7%); upper eyelid ectropion – 3 (4.0%); thyroid associated lid retraction – 2 (2.7%), leaving 17 patients with involutional ectropion (22.7%) . Of these, 14 (82.4%) were male and 3 (17.6%) were female, with mean age at time of surgery 79.1 years for the men and 80.3 years for the women (range 64-90). This was statistically significant (p=0.002) compared to the distribution of males in all new patients greater than 60 years old presenting during the study period (416/970 = 42.9%). Eight of the 14 men (57.1%) and 2 of the 3 women (66.6%) had prior intraocular surgery. Conclusions: Involutional ectropion is a significant source of morbidity for the aging population, potentially leading, in untreated cases, to chronic conjunctival inflammation, punctal stenosis and epiphora, exposure keratopathy, and cosmetic deformity. This study, though retrospective and limited to patients requiring repair in an oculoplastics clinic, reveals a highly statistically significant association between involutional ectropion and male gender. This suggests a clinically significant difference in the anatomy and/or aging process of the lid and adnexal structures in males and females.

Keywords: eyelid • clinical (human) or epidemiologic studies: pre • anatomy 
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