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Audrey Y. Pang, Llewellyn K. Lee; Lower Lid Retractor Repair for Lower Eyelid Involutional Entropion in East Asian Patients. Invest. Ophthalmol. Vis. Sci. 2011;52(14):727.
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Lower eyelid entropion leading to ocular irritation and damage is common, especially in aging adults. The malposition of the eyelid is attributed to a number of mechanisms such as horizontal lid laxity and over-riding preseptal orbicularis. Several surgical procedures to correct lower eyelid entropion have been documented, but the lower lid retractor repair has not been reported previously. We aim to evaluate the effectiveness of the lower lid retractor repair in correcting involutional entropion in an East Asian population in a tertiary care hospital in Singapore.
Retrospective review of patients who underwent lower lid retractor repair surgery for involutional entropion at the National Healthcare Group Eye Institute in Singapore from 2004 to 2010.
121 patients were identified, of which 88 were followed up for at least 6 months. Of these 88 patients, a total of 97 lower lid retractor repair procedures were performed for involutional entropion. In 9 patients, both eyes were affected and they underwent bilateral lower lid retractor repair. Of these 97 surgical procedures, only 1 eyelid (0.1%) developed recurrent entropion within 6 months post-operatively. There were no complications noted during this period. Outcomes were good, with the majority of eyelids (n=96, 99.9%) being well corrected. Post-operative ectropion was not seen in this group.
Involutional lower eyelid entropion is commonly seen in patients of East Asian descent. It can give rise to symptoms of tearing and discomfort and lead to keratopathy. We have established a novel surgical technique of lower lid retractor repair which is a simple and effective approach in correcting involutional entropion. It provides a good surgical outcome and a low recurrence rate.
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