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Impressum
Results after various lower lid entropion procedures
Klink T., Münnich S., Höhne S., Lieb W. E.
Universitäts-Augenklinik, Josef-Schneider-Str. 11, D-97080 Würzburg
Introduction: There are numerous surgical techniques for entropion
repair. The therapy of choice depends on pathogenesis, previous surgery
and general health of the patient. Purpose of this study was to evaluate
the entropion procedures concerning functional results, complications
and recurrencies.
Patients and methods: For the period between 1995-2000 the records
of 270 patients were examined, who had undergone surgery for entropion
at the university eye hospital Würzburg and out of those 163 patients
(196 eyes), (involutional 184, scars 7, congenital 1, Sturge-Weber-Syndrome
1), have been evaluated retrospectively. The mean follow-up period was
15,8 months, the average age 73,5 ±11 years. 102 women and 61 men
were treated. 20 patients have had previous surgery. The primarily performed
surgical techniques were: suture repair (38), Jones procedure (87; 15
with horizontal lid shortening, 1 with lateral canthal sling), Wies (32),
Quickert (16), Blaskowicz (6), weakening of orbicularis muscle (3), horizontal
lid shortening (9), lateral canthal sling (4), Posterior conjunctival
graft (lower lid) (1).
Results: A cure after primary surgery was achieved in 78,6% (154)
the recurrence rate 21,4%. The recurrency occurred in average after 11,5
months. In 90,5% of the unsuccessful primary surgeries was no horizontal
shortening done (Jones procedures 29, suture repairs 6, Wies procedure
3). No reoperation was in half of the recurrencies (21) performed. The
majority of reoperations were performed with horizontal lid shortening
(13). Late complications were sensory abnormalities (2) and a suture granuloma.
Conclusions: The results show that horizontal lid shortening plays
beside the disinsertion of the lower lid retractors an important role
in successful and permanent correction of lower lid entropion.