Efficacy of two surgical approaches in correction of severe upper eyelid cicatricial entropion / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare the efficacy of two surgical approaches that microscopical Hotz combined with eyelid margin incision and flap translocation and pure Hotz method in correction of severe upper eyelid cicatricial entropion. <p>METHODS: Totally 84 eyes of 60 patients who underwent corrective surgery for upper eyelid trichiasis between July 2017 to July 2019 were retrospectively assessed. The patients in trial group(32 cases, 42 eyes)underwent the surgical procedure of combining Hotz with eyelid margin incision and skin flap transposition under microscope, the other group(28 cases, 42 eyes)were treated with Hotz method. The follow-up time was 12mo. Subjective symptoms, eyelid marginal position, eyelash eversion and patient satisfaction were recorded.<p>RESULTS: The surgery time of one eye in trial group was longer than that in control group(40.8±2.57min <i>vs</i> 28.5±2.64min, <i>P</i><0.01). The cure rates of 1 and 12mo in trial group were 100% and 95%, respectively. And those in control group were 95% and 76%, respectively. The cure rate of 12mo in trial group was higher than that of the control group(<i>P</i>=0.013). There was no significant difference in patient satisfaction between the two groups at 1mo after surgery(<i>Z</i>=1.1825, <i>P</i>=0.2371). 12mo after surgery, patient satisfaction in the trial group was higher than that in the control group(<i>Z</i>=3.7346, <i>P</i><0.01).<p>CONCLUSION: While it spents longer time, the procedure of combining Hotz with eyelid margin incision and skin flap transposition under microscope is reasonably successful and satisfactory in rectifying severe upper eyelid cicatricial entropion. It offers more higher cure rate than Hotz alone at long time after operation.

Genetic analysis and clinical phenotype of a family with lymphedema-distichiasis syndrome / 浙江大学学报·医学版

OBJECTIVE@#To identify the genetic causes of a family with lymphedema-distichiasis syndrome (LDS).@*METHODS@#The whole exome sequencing was performed in a aborted fetus as the proband, and a candidate gene was identified. Peripheral blood of 8 family members were collected. Genotypic-phenotypic analysis were carried out through PCR amplification and Sanger sequencing.@*RESULTS@#The proband, and the mother, grandmother, uncle, granduncle of the proband all had distichiasis or varix of lower limb carried a @*CONCLUSIONS@#The

Observation on the curative effect of congenital double ciliary correction in children / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the clinical effect of correction of congenital districhiasis in children by gray line incision and hair follicle root excision.<p>METHODS: Thirteen eyes of 8 patients with congenital districhiasis admitted to our hospital from September 1990 to October 2015 were collected. Under general anesthesia or local anesthesia, all the patients were admitted gray line incision and hair follicle root excision. The patients were followed up for 3mo-5a to observe the prognosis.<p>RESULTS: All the patients' wounds had healed and the eyelid activity was not affected 48h after the operation. Patients were followed up and observed and their districhiasis had completely corrected after surgery. The incision of the gray line of the eyelid margin healed smoothly, no eyelid margin deformity and surgical scar formated. The anterior eyelid lashes were not disturbed by surgery and no entropion, ectropion or trichiasis were found. The posterior lip of the eyelid margin is sharp and flat, keeping the angle of contact with the surface of the eyeball. No entropion or ectropion formation,and no abnormal tear conduction were found, no residual eyelashes. There was no corneal irritation, and the corneal surface infiltration lesion healed.<p>CONCLUSION: Gray line incision and hair follicle root excision is effective surgery in correction of congenital districhiasis in children with low recurrence rate. The operation is simple and meets the requirements of eyelid physiological function and appearance.

Ectopia cilia with pedigree analysis: Second case report in the world.

We present a case of ectopia cilia in a 28‑year‑old male patient. Ectopia cilia was were seen in the outer third of left upper eyelid. The patient’s maternal grandfather also had ectopia cilia of the left upper eyelid as reported by the patient’s mother. Ectopia cilia is a rare condition seen in humans. Only 12 cases of ectopic cilia in humans have been reported so far in the world. The present case of ectopia cilia is the second case report in the world with pedigree analysis.

Lymphoedema - distichiasis syndrome with recurrent abortions.

Lymphoedema-distichiasis syndrome, a type of familial lymphoedema praecox, is a rare, primary lymphoedema of pubertal onset associated with distichiasis and other associations including congenital heart disease, ptosis, varicose veins, cleft palate, and spinal extradural cysts. We report a case of familial lymphoedema with associated distichiasis, atrial septal defect, varicose veins, and recurrent abortions in a 29-year-old female.

Treatment of Distichiasis or Trichiasis combined with Entropion

PURPOSE: To evaluate the clinical efficacy of a reverse eyelid splitting technique that we performed in cases of trichiasis or distichiasis combined with entropion. METHODS: The study comprised 43 eyes of 31 patients with trichiasis or distichiasis combined with entropion treated from November 2004 to December 2005. After skin incision, the muscular layer and tarsus were reversely dissected to find abnormal follicles. The abnormal hair follicle was cauterized under the muscular layer, and 2~3 rotating sutures were done with Ethilon 6-0 to fix the tarsus and skin. Success was defined as having the meibomian gland located in front of the junction of skin and mucosa, without an abnormal hair protruding into the eye for at least three months. RESULTS: Fifteen patients were male and sixteen patients were female. The mean age was 62.1+/-15.2 years. The patients were followed up for an average of 12.4+/-2.0 months after surgery. Surgery was successful in 74.4% (32 of the 43 eyelids) of the cases, and the recurrence rate was 25.6% (11 of the 43 eyelids). No severe complications occurred, such as infection, hemorrhage, wound dehiscence, or granuloma. However, foreign body sensation (1 eye) and eyelid notch (l eye) did occur. CONCLUSIONS: This reverse eyelid splitting technique produced satisfactory results in both cosmetic and functional aspects. Moreover, it resulted in a low recurrence rate and low complication rate in patients with trichiasis or distichiasis combined with entropion.

Treatment of Trichiasis and Districhiasis with Ellman Dento-Surg 90FFP

PURPOSE: To evaluate the efficacy of the Ellman Dento-Surg 90FFP for the isolated trichiasis or distichiasis. METHODS: 61 eyelashes of 23 patients, who were diagnosed as trichiasis or distichiasis and had less than 5 aberrant cilia that were isolated, were treated with the Ellman Dento-Surg 90FFP. At 1 week, 1 month, 2 month and 6 month postoperatively, we examined the success rate and postoperative complication. RESULTS: Fifteen eyelashes of 9 patients were regrown after mean 1.3month follow-up period (75.4% success rate). Among 10 eyelashes of 6 patients, 2 eyelashes of 2 patients were regrown (80% success rate). Thirteen patients experienced mild burning sensation 1-2 days postoperatively. Eyelid notching was observed in 2 patients. CONCLUSIONS: High frequency radio wave electrosurgery with Ellman Dento-Surg 90FFP is a simple and secure procedure with high success rate and negligible complication, and can be effectively used to treat isolated trichiasis or distichiasis.

Effect of Full-thickness Pentagonal Wedge Resection for Treatment of Localized Trichiasis and Distichiasis

We evaluated the efficacy of the full-thickness pentagonal wedge resection for localized trichiasis and distichiasis. Fourteen eyes of eleven patients, who were diagnosed to have trichiasis and distichiasis from October 1995 to October 1997 and had more than 10 aberrant cilia that were clustered together, were included in this study. More than 2 months later, we examined clinical symptoms, recurrent aberrant cilia, and complications. There was no recurrence in 11 lids. In 3 lids there were one to three recurrent aberrant cilia around resection margins, and the patients had mild foreign body sensations. In 2 of 3 cases of symptomatic recurrence, symptoms improved after argon laser treatment. Although one case showed recurrence after argon laser treatment, the patient remained asymptomatic. There were no significant complications including postoperative scarring. Therefore, we suggest that the full-thickness pentagonal wedge resection may be simple and effective for the treatment of trichiasis and distichiasis clustered with many aberrant cilia, especially in high risk patients who have potential for corneoconjunctival complications.

Lid Splitting and Posterior Lamellar Cryosurgery for Congenital Distichiasis

Congenital distichiasis is a rare condition in which accessory row of lashes is present in place of the Meibomian gland orifice. These aberrent ciliae irritate the cornea and conjunctiva and therefore cause epiphora, photophobia, conjunctival injection, corneal erosions, and may develop into opacification. All four patients from the same family who had anomalous row of lashes in their eyelids complained of the same persistent ocular irritation along with strabismus and ptosis. We performed, on all of the four patients, lid splitting along the gray line and cryotherapy to the posterior lid lamella where the follicles of aberrent ciliae are located, and excised redundant skin of upper and lower lids. By these operations, all four patients showed improvement in their ocular irritaton. We report clinical presentation of four patien~s of congenital distichiasis and believe lid splitting and cryosurgery is effective method for congenital disti chiasis.

New Operation Method on the Cicatricial Entropion and the Distichiasis

The term "entropion" is defined as a turning inward of the eyelid. Depending on the mechanism of its causation, it may be classified into four types; mechanical, spastic, senile, and cicatricial. Cicatricial entropion follows scarring of the palpebral conjunctiva, which may be caused by trauma, chemical injuries, infections such as trachoma, benign ocular pemphigus, Stevens-Johnson syndrome, and eyelid surgery. Distichiasis is a rare congenital anomaly in which aberrant separate row of lashes usually composed of hairs smaller than normal, appears along the posterior lid margin. Numerous surgical procedures have been described for surgical correction of cicatricial entropion and distichiasis in accordance with the severity of the condition. We have treated cicatricial entropion in 6 eyes(8 lids) and distichiasis in 3 eyes (3 lids) with sliding tarsoconjunctival grafting, and the results were satisfactory.