Long-term Results of Interrupted Buried Suture Method Using Non-absorbable Material for Involutional Lower Lid Entropion

ABSTRACT

PURPOSE: To introduce and evaluate the long-term effectiveness of interrupted buried suture using non-absorbable material in involutional lower lid entropion. METHODS: A total of 105 adult involutional lower lid entropion patients (135 eyes) from January 2010 to January 2015 with or without the horizontal laxity, and without a history of previous surgical treatment were included. Exclusion criteria included patients with cicatricial entropion, epiblepharon, history of previous lower lid surgery, and follow-up period less than 3 months. The central and lateral areas below the lower lid margin and below the inferior tarsal margin were connected by non-absorbable interrupted buried suture. Results were analyzed by objective outcome using measurements from clinical photographs, subjective outcome using improvements of patients' symptom and cosmetic satisfactions. RESULTS: This study included 135 eyelids. Pre-operative distraction test revealed horizontal laxity in 37 eyes (27.4%). The mean age was 79.50 years and the mean period of follow-up was 34.51 ± 3.8 months. In 133 eyelids (98.5%), post-operative lid positions have everted. Score of symptom improvements were 9.44 (0 to 10 scale). 99 patients (94.3%) were cosmetically satisfied. No surgical complications were observed. Although we had two recurred cases (1.5%), one with horizontal laxity (2.7%) and one without horizontal laxity (1.0%), reoperation was not performed due to mild subjective discomfort. CONCLUSIONS: For patients with involutional entropion regardless of horizontal laxity, a simple interrupted buried suture method using non-absorbable suture material showed excellent long term results in very low recurrence rate and high cosmetic satisfaction.