Entropion and ectropion repair: a snapshot of surgical practice in the United Kingdom.

We aim to provide a snapshot of the current surgical practice for correction of entropion and ectropion, the two most common oculoplastic procedures carried out in the UK, by surveying 135 consultant oculoplastic surgeons via the tool Survey Monkey. Forty-seven (35%) consultants responded. For entropion, 44% of surgeons opted for lateral tarsal strip (LTS) + everting sutures (ES). Other first-line choices included LTS + transcutaneous retractor plication (21%), Quickert's procedure (14%), ES (7%), and Wies procedure (5%). Important patient-related factors to consider were horizontal lid laxity and retractor dehiscence. Regarding ectropion, LTS was most commonly practiced (35%), followed by LTS + transconjunctival retractor plication (28%), wedge excision (16%), and lateral canthoplasty (5%). The patient-related factors guiding choice were horizontal lid laxity, lateral canthal tendon laxity, and punctal position under traction. Responses found a wide range of preferred surgical techniques in practice. The factors guiding surgical choice were personal audit results (92% stated important/very important), familiarity with the technique (92%), and the technique being favoured by previous trainers (76%), suggesting current practice led by expert opinion, possibly due to a lack of evidence-based literature. This highlights the variety of core oculoplastic surgical techniques practiced and underlines the need for robust trials to guide surgical choice.

Upper Eyelid Reconstruction Using a Blepharoplasty Flap.

PURPOSE: The blepharoplasty flap is a relatively simple but under-recognized surgical technique for repairing defects that result from excision of broad-based lesions on the upper eyelid that lie between the eyelid crease and the eyelashes. As this has not been previously published in the literature, the authors aim to increase the awareness of this technique. METHODS: The eyelid crease is marked. A line is drawn perpendicular to the crease line along the aspect of the lesion closest to the centre of the eyelid, dividing the eyelid into 4 quarters. The lesion is excised along with the area lying diagonally. An advancement flap is then fashioned from excess skin of the upper eyelid and moved inferiorly to close the defect. RESULTS: The resulting cosmetic results seen postoperatively have been excellent. CONCLUSIONS: The blepharoplasty flap is a style of surgical advancement flap that utilizes the tissue that would normally be excised during blepharoplasty. This straightforward technique can prove useful in the surgical repertoire due to its potential to be widely adopted in surgical practice.

The eye drop chart: a pilot study for improving administration of and compliance with topical treatments in glaucoma patients.

AIM: In order to improve patient education, compliance, and administration of eye drops prescribed for patients suffering with glaucoma within a UK ophthalmology department, an eye drop chart (EDC) was designed, developed, and piloted with patients attending the glaucoma clinic over 1 month. METHODS: A cross-sectional prospective pilot study of 25 patients using an administration aid and a self-reported questionnaire. Chi-square tests were used to compare responses pre- and postintervention. RESULTS: Results demonstrated an impressive improvement in nine of eleven categories assessed regarding drop administration and compliance. Patients stating that they always wash their hands increased significantly from 64% (13 participants) to 92% (23 participants) (P=0.029), and those who always shake the bottle improved from 40% (10) to 84% (21) (P=0.001). Punctal occlusion techniques improved from 44% (11) to 72% (18) (P=0.015). Finally, patients who always discarded the bottle after 28 days of use rose from 68% to 92%, though the difference was not significant (P=0.09). Only the number of drops being administered to the eye and the length of time left between the application of drops remained relatively unchanged. Sixty-four percent reported finding EDC helpful or useful, 52% had positive responses when asked if they would continue using EDC, and 88% would recommend it to a friend. CONCLUSION: Although there are limitations to the data as they are subjective, descriptive, and limited to sample size of 25, the results of this pilot study have shown promise. The EDC appears to be a cost-effective way at improving patients' use of topical ocular medications.