Abstract
Purpose :
To evaluate the effectiveness of horizontal eyelid tightening and fornix suture placement in the surgical management of lower eyelid involutional entropion.
Methods :
This retrospective study reviewed 602 lower eyelids (484 patients) with involutional lower eyelid entropion who underwent surgical repair between August 2010 through September 2020 in a community subspecialty oculoplastics practice. All patients were followed for greater than three months postoperatively. Exclusion criteria included inadequate follow up or multi component lower eyelid entropion. ICD 9 code 374.01 and ICD 10 codes H02.032 and H02.035 were used to identify charts for review.
Results :
658 patient charts were reviewed with a diagnosis of lower eyelid involutional entropion. Of these, 602 eyelids of 484 patients (56% male, 44% female; age range 50-100 years old, 98% >60 years of age; 52% left lower eyelid, 48% right lower eyelid) underwent entropion repair combining horizontal eyelid tightening with full thickness forniceal (Quickert) sutures. With at least three months follow up (range 3-60 months), the recurrence rate of lower eyelid entropion was 1.2% (7/602 eyelids). Of these recurrences four out of the seven were noted to have significant enophthalmos preoperatively. Another 1.2% (7/602 eyelids) developed sequential ectropion, which required surgical correction between one and twelve months following the original surgery. Suture abscesses, while uncommon, were present in 1.8% (11/602 eyelids) and managed with oral and/or topical antibiotics. Four of those patients underwent removal of the Quickert sutures. None of these cases resulted in recurrent entropion.
Conclusions :
Horizontal lower eyelid tightening and Quickert (fornix) sutures are a reliable and effective management of lower eyelid involutional entropion with low recurrence and complication rates. We believe this is the largest known review of the success of this procedure to date.
This is a 2021 ARVO Annual Meeting abstract.