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Olivier Galatoire, Chrysanthi Basdekidou, Blandine Langlois, Pierre-Vincent Jacomet; Managing Cicatricial Ectropion. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1566.
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Cicatricial ectropion is secondary to the retraction of the anterior lamella of the eyelid. Surgical management consists in correcting the lid defect often associated with a skin graft.
Retrospective study of 10 cases operated on for cicatricial ectropion. Studied parameters include patient’s age, affected lid, the pathogenical mechanism responsible for the cicatricial ectropion, surgical technique, mean follow-up and final anatomic result.
Mean patients age was 60 years old. Concerning the pathogenical mechanism of the cicatricial ectropion, it was the result of traumatism (n=5), palpebral tumor (n=3), facial burn (n=1), local irradiation (n=1). In 2 cases the ectropion concerned both eyelids of the same eye while in the rest of the cases only the lower eyelid was affected. Five patients benefited from a lateral canthal sling associated with a simultaneous skin graft (2 subclavicular grafts, 2 opposite upper lid grafts), 2 patients received a skin graft as secondary surgery and the rest 3 patients benefited from a Z-plasty, 2 of which were associated with a lateral canthal sling. Post operative treatment consisted in applying antibiotic and healing ointments. Mean follow up was 13 months. At the last visit all patients presented satisfying anatomical and functional results.
Z-plasty is applied for the treatment of small tractions and linear scars. This technique can be associated with a lateral canthal sling for enhanced anatomic results. Skin grafts are the treatment of choice for more important tractions. Full skin grafts are preferred to split-thickness skin grafts for correcting diffuse scars. Cicatricial ectropion is a complication that demands an adjusted and personalised surgical treatment.
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