Entrecruzamiento del orbicular para el entropión senil mediante técnica de Martínez-Rodríguez modificada / Orbicularis Crosslinking for Senile Entropion Using the Modified Martinez-Rodríguez Technique

Objetivo: Describir los resultados de la técnica de entrecruzamiento del orbicular, descrita por profesores eméritos del Pando Ferrer, en el entropión senil. Métodos: Se realizó un estudio observacional descriptivo longitudinal retrospectivo con pacientes atendidos en el Instituto Cubano de Oftalmología Ramón Pando Ferrer entre enero del 2021 a junio de 2022. La muestra estuvo constituida por pacientes operados con entropión senil con la técnica de Martínez Rodríguez modificada. Se les realizó examen ocular completo con seguimiento a las 24 h, 7 y 15 días, al mes y a los tres meses posteriores a la cirugía. Las variables utilizadas fueron edad, sexo, lateralidad, tiempo de cirugía y complicaciones. Resultados: La edad media fue de 79,26 años, con predominio del sexo masculino (69,56 por ciento) en 23 pacientes y 26 párpados; siendo 20 casos unilaterales y 3 bilaterales. Se reportó una complicación de hipocorreción (3,84 por ciento) y un tiempo medio de 11,9 minutos. Conclusiones: La técnica descrita es un abordaje efectivo demostrado en la baja frecuencia de complicaciones, sencillo y poco invasivo para entropión senil sin laxitud horizontal grave(AU)

Objective: To describe the results of the orbicularis crosslinking technique, described by emeritus professors from Pando Ferrer institute, in senile entropion. Methods: A retrospective, longitudinal, descriptive and observational study was carried out with patients who received attention at Instituto Cubano de Oftalmología Ramón Pando Ferrer between January 2021 and June 2022. The sample consisted of patients with senile entropion operated on with the modified Martinez-Rodriguez technique. They underwent a complete ocular examination with follow-up at 24 hours, 7 and 15 days, one month and three months after surgery. The used variables were age, sex, laterality, surgery time and complications. Results: The mean age was 79.26 years, with a predominance of the male sex (69.56 percent) in 23 patients and 26 eyelids; there were 20 unilateral cases and 3 bilateral ones. One complication of hypocorrection (3.84 percent) and a mean time of 11.9 minutes were reported. Conclusions: The described technique is an effective approach for senile entropion, demonstrated according to the low frequency of complications, as well as simple and minimally invasive and without severe horizontal laxity(AU)

Treatment efficacy of eyelid twitch muscle transposition surgery in senile entropion / 国际眼科杂志(Guoji Yanke Zazhi)

AlM:To explore treatment efficacy of the lower eyelid twitch muscle transposition surgery in senile entropion.METHODS:Fifty cases (86 eyes) of senile lower eyelid entropion patients underwent lower eyelid twitch muscle transposition correction surgery as the experimental group, and the other 42 cases (68 eyes) of senile lower eyelid entropion patients received orbicularis muscle shortening correction as controls group. The correction rate, double eyelid symmetry and overcorrection rate of patients were observed one week after surgery. The patients were followed up for 6~12mo to be observed the long-term recurrence rate, double eyelid symmetry and overcorrection rate.RESULTS: One week after operation, eyelid symmetry, overcorrection rate of experimental group and control group had significant difference (P<0. 05); After followed up for 6 ~12mo, eyelid symmetry, overcorrection rate of experimental group and control group had significant difference (P<0. 05). CONCLUSlON: Folding and orbicularis muscle shortening treatment of senile entropion was compared with the lower eyelid twitch muscle transposition surgery treatment of senile entropion, We can find that clinical results in double eyelid surgery symmetry and overcorrection rate are of obvious advantage.

Clinical observation of orbicularis muscle shortening improved treatment for senile entropion / 国际眼科杂志(Guoji Yanke Zazhi)

To analyze the clinical results of orbicularis muscle shortening surgery and eyelid skin orbicularis muscle resection for senile entropion. ●METHODS: From January 01, 2006 to December 31, 2012, senile patients with lower eyelid were divided into two groups according to different surgical methods. Group A with the orbicularis muscle shortening improved operation in 20 cases (38 eyes), group B used the eyelid skin orbicularis muscle resection in 21 cases (36 eyes). The effects of surgery were followed-up postoperatively. ●RESULTS: Patients were followed up for 1 - 2a, 20 patients ( 38 eyes ) in group A were cured without recurrence; 7 eyes recurred in group B, the recurrence rate was 19%, the recurrence rate after surgery both groups were statistically significant (P ●CONCLUSlON: The effect of orbicularis muscle shortening improved operation for senile entropion is good and stable.

The Characteristics of Senile Entropion of Lower Eyelid with Kinked Tarsus

PURPOSE: To report the clinical features and surgical results for lower lid entropion with kinked tarsus compared with entropion with weakened capsulopalpebral fascia. METHODS: From March 2008 to December 2009, 20 patients (24 eyes) with lower lid entropion were examined. The patients were divided into the aggravated entropion with kinked tarsus group or the weakened capsulopalpebral fascia group based on the height of tarsus, the shapes of the lower lid and tarsus, and conjunctiva changes. For treatment of entropion in the kinked tarsus group, full thickness tarsotomy with rotatory suture (tarsal fracture operation) was performed, and in the weakened CPF group, a CPF tight procedure was performed. The results of the operations were retrospectively evaluated. RESULTS: The mean age of the patients with entropion in the kinked tarsus group (15 cases) was 66.7 +/- 11.4 years, and the mean age of the patients with entropion in the weakened CPF group (9 cases) was 67.2 +/- 6.2 years. The height of the lower lid tarsus of each group was 3.80 +/- 0.39 mm and 5.20 +/- 0.30 mm, respectively. Except for one case of recurrence after tarsal fracture operation in the kinked tarsus group and reoperation with CPF tightening, there were no significant complications or recurrence in either group. CONCLUSIONS: Entropion with kinked tarsus was more common than entropion with weakened CPF in the present study. In addition, surgical treatment based on the shape and cause of entropion showed good results.

The Effect of Single Suture Inferior Retractor Tightening for Senile Entropion

PURPOSE: To evaluate the clinical efficacy of a simplified single suture inferior retractor tightening technique in senile entropion. METHODS: Twenty patients (26 eyes) showing no severe horizontal lid laxity underwent an operation for senile entropion between April 2001 and July 2003. After a subciliary incision, the inferior retractor was identified, and repaired by reattaching the superior edge of the inferior retractor to the inferior edge of the lower tarsus using a single 5-0 Prolene suture. RESULTS: The patients were followed up for an average of 2.8 months after surgery. Five patients showed complications: two overcorrections and three recurrences of entropion. The others all showed good cosmetic and functional results. The recurred cases underwent further operation with good results. CONCLUSIONS: The simplified single suture inferior retractor tightening gave good results in patients with senile entropion without severe horizontal lid laxity. Moreover, this procedure has short operation and recovery times. In unilateral cases, more symmetric appearances were obtained compared with combined surgeries.

The Capsulopalpebral Fascia Repair for Senile Entropion

PURPOSE: We report that simple capsulopalpebral fascia (CPF) repairs were effective when patients diagnosed as senile entropion had the disinsertion lines of the CPF on everted lower conjunctivas (demarcation line). METHODS: Twenty patients (27 eyes) who had demarcation lines and showed no severe horizontal lid laxity were operated for senile entropion during the period March 1, 1996 to July 30, 2001. After subciliary skin incision, the disinserted CPF was identified and repaired by reattaching the superior edge of the CPF to the inferior edge of the lower tarsus. RESULTS: This procedure was performed on 27 eyes of 20 patients (women 11, men 9, average age 68.6 years). We followed up the patients from 3 to 30 months after surgeries (average 7.8 months). Two patients showed complications, one was conjunctival prolapse and the other was recurrence of entropion. CONCLUSIONS: Simple capsulopalpebral fascia (CPF) repairs gave good results in patients with senile entropion who had disinsertion lines of the CPF on everted lower conjunctiva (demarcation line) without severe horizontal lid laxity. Moreover this procedure had shorter operation and recovery times compared with other combined surgeries.

Surgical Treatment of Sensile Entropion

Senile entropion is caused by following pathophysiologic changes ; disinsertion or weakness of lower lid retractor, upward migration and overriding of the preseptal orbicularis oculi muscle over pretarsal orbicularis muscle, horizontal lid laxity, and relative enophthalmos from absorption of orbital fat. There have been numerous procedures to correct senile entropion, but the difficulty of adequate and concurrent correction of all of the underlying defect result in high recurrence rate. Therefore, authors performed a combined procedure including reattachment of disinserted lower lid retractor or tucking of weakened lower tarsus, and the extirpation of overriding preseptal orbicularis oculi muscle. At the same time we performed the correction of the lower lid laxity using lateral tarsal strip procedure of full-thickness wedge resection. Authors performed this method in 21 cases of 17 patients and the cosmetic and functional result were satisfactory.

Surgical Correction of Senile Entropion

Senile entropion is caused by following pathophysiology: 1) Dehiscence or disinsertion of lower lid retractors from lower tarsus, 2) Preseptal orbicularis overriding pretarsal orbicularis, 3) Horizontal lid laxity from involutional changes of medial canthal ligament, lateral canthal ligament and tarsal plate, 4) Relative enophthalmos from absorption of orbital fat. There have been numerous procedures to correct senile entropion, but lack of adequate correction of all of the underlying anatomic defects resulted in high recurrence rate. Authors performed a combined procedure including the reinsertion of disinserted or dehisced lower lid retractor to lower tarsus, the excision of overriding preseptal orbicularis, and the correction of the lower lid laxity using lateral tarsal strip procedure all at once Among 11 cases of 10 patients, 10 cases had cosmetically and functionally good lid position during the mean follow up periods of 13.4 months. There was one case of ectropion as a complication which was corrected by further lateral tarsal strip procedure.

Correction of Senile Entropion by Full Thickness Lid Excision

Senile entropion remains something of an enigma, with no general agreement as to etiology or best surgical treatment. Little basic research on the problem of senile entropion had been carried out until Dalgleish and Smith inserted metal markers into the various anatomical layers of the lower lid and took lateral rediographs. As the results of their investigations, they showed that surgical intervention should be directed towards the correction of two important features in the etiology of senile entropion-rotation of the tarsal plate and loss of attach ment of skin and orbicularis to the deeper tissues. O'Donoghue and Roden reported that they could be corrected by excising a full-thickness triangle, apex up, from the central part of the lower lid. Three cases of senile entropion and one vase of spastic entropion were treated with the same procedure as O'Donoghue and Roden did except the excision of the redundant skin along the lowere lid margin. The results of our procedure was simple and successful.