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Abstract
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.
References
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Figure 1.
Entropion with kinked tarsus of the left lower eyelid in a 66 year old male patient. (A) Left lower eyelid with severe entropion and inferior cornea cilia touch. (B) Left lower eyelid with kinked tarsus and traction. (C) Entropion with kinked tarsal plate and conjunctival grooving was found upon eversion along with a blunt lid margin and conjunctival injection on slit lamp exam.
Figure 2.
Entropion of both lower eyelids with kinked tarsus in the left lower eyelid and weakened capsulopalpebral fascia in the right lower eyelid in a 77 year old female patient. (A) Entropion was found on both lower eyelids without traction and the cilia of the left lower eyelid appeared more inverted than the right. (B) Lower eyelid traction test with equal power was done on both lower eyelids. Entropion with kinked tarsus was found in the left lower eyelid and entropion with weakened capsulopalpebral fascia in the right lower eyelid. Signs of severe conjunctival injection, chemosis, and blepharitis were found to be more prominent in the left eye versus the right eye.
Table 1.
Demographics and clinical characteristics of Senile entropion†
| Entropion with kinked tarsus | Entropion with weakened CPF* | |
|---|---|---|
| Age (mean ± SD, yr) | 66.7 ± 11.4 (47–86) | 67.2 ± 6.2 (59–76) |
| Sex | ||
| M:F (eye) | 6:7 (8:7) | 3:5 (3:6) |
| Eye | ||
| OD (eye) | 6 | 4 |
| OS (eye) | 9 | 5 |
| Follow up (mean ± SD, mon) | 2.87 ± 2.03 (1–6) | 3.00 ± 2.29 (1–6) |
| Height of inferior tarsus (mean ± SD, mm) | 3.80 ± 0.39 (3.0–4.3) | 5.20 ± 0.30 (4.6–5.5) |
| Recurrence of entropion (eye) | 1† | 0 |
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