Comparison between two surgical methods for eyelid ectropion: tarsal strip alone versus tarsal strip with punctoplasty (three snips with or without diamond-shaped resection).

Abstract

Purpose : Ectropion of the eyelid can lead to skin retraction, stenosis of lacrimal point, chronic watering, visual discomfort or low visual acuity, mostly when it occurs with ectropion of lacrimal point. The objective of the study is to compare two surgical strategies for eyelid ectropion combined with ectropion of the lacrimal point.

Methods : We included all consecutive patients who underwent eyelid ectropion surgery in our department from Oct 2014 to Oct 2015. The first procedure is lateral tarsal strip alone (group 1); the second one is lateral tarsal strip with three snips with or without diamond-shaped resection (group 2). The authors focused on the alteration of the quality of life related to watering, before and after operation. Quality of life related to discomfort due to watering was evaluated before and after surgery using a questionnaire. Informations have been gathered via phone with a ten items questionnaire, each item is worth 0 (no or minim discomfort due to watering) or 1 (discomfort due to more than moderated watering).

Results : Twenty-two eyelids from eighteen patients were included, eleven in group 1 and eleven in group 2. Average age was 79 ± 11 year-old in group 1 and 80 ± 9 in group 2. The five more relevant items were: reading capacity, watching TV, outdoor activities, social interaction and general well being. For reading: respectively in group 1 and 2, 82 % and 91 % of the patients were discomfort before surgery while 18 % and 0 % after surgery. For watching TV: 82 % and 91 % before surgery while 9 % and 9 % after. For outdoor activities: 91 % and 100 % before surgery while 0 % and 0 % after. For social interaction: 80 % and 90 % before surgery while 0% and 0% after surgery. For global well being, respectively 90 % and 70 % before surgery, while 0 % and 0% after surgery.

Conclusions : Our study proves effectiveness of both surgery strategies to improve patients' discomfort due to watering. Contrary to our initial assumption, both strategies lead to similar results, which would be in favor of a surgery as little invasive as possible. A larger sample size will be necessary to demonstrate any superiority of lacrimal point surgery.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.