Long-term outcomes of eyelash-sparing surgical technique for severe segmental cicatricial entropion.

PURPOSE: To assess the long-term outcomes of segmental entropion correction using anterior lamellar recession (ALR) with mucous membrane graft (MMG). METHODS: Prospective interventional study of 16 patients (mean age, 35.3 ± 16.3 years; 10 females) with severe segmental cicatricial entropion, managed using ALR and MMG. Outcome measures include eyelid and eyelash status, changes in the ocular surface, visual acuity, and cosmetic appearance at a minimum nine months of follow-up. RESULTS: Of 16 patients (16 eyelids), 11 had Stevens-Johnson Syndrome (SJS) and five had chemical injury. The most common location of entropion was medial (87.5%) followed by central and lateral. All patients had severe entropion with trichiatic eyelashes. Anatomical success was 87.5% (14/16) at six weeks of follow-up. Residual trichiasis was managed with a repeat ALR with MMG in one and eyelash resection in the other eyelid. The etiology-wise success rates were 90% in SJS and 80% in chemical injury. At the final mean follow-up of 14.8 months, entropion was corrected in 100% of eyelids. None of the patients had cosmetic concerns. Ocular surface symptomatology and visual acuity improved in 87.5% of patients and 40% of eyes, respectively. CONCLUSION: Anterior lamellar recession with lid margin mucous membrane grafting successfully repairs the severe segmental cicatricial entropion without raising any cosmetic concerns.

Simplified medial canthoplasty: Technique and early postoperative complications in 601 dogs (1180 eyes).

PURPOSE: To present a novel modified medial canthoplasty (MCP) technique, the application in 601 dogs (1180 eyes), and a review of the early postoperative complications related to the technique. INTRODUCTION: Macroblepharon and nasal entropion is a common presentation in many brachycephalic dog breeds promoting chronic keratitis. The previously described MCP techniques limit the medial shortening of the eyelids to the location of the lacrimal puncta. A novel technique was developed allowing for a more extensive eyelid shortening nasally. METHODS: The modification of the here described technique includes the longitudinal splitting of the lacrimal canaliculi allowing for an extensive shortening of the lids beyond the lacrimal puncta. Records of 601 dogs which underwent the modified MCP were reviewed regarding breed, indications for surgery, follow-up, and early postoperative surgical complications. Descriptive statistics were applied. RESULTS: Six hundred one dogs (1180 eyes) were included in this study. Twenty-four different breeds underwent the simplified MCP with the Pug (n = 403) being the most represented breed. Indications were macropalpebral fissure, medial entropion, pigmentary keratitis, trichiasis by haired caruncle, strabismus after globe prolapse, and facial nerve paralysis. The overall complication rate was 1.01% (12/1180) and consisted of wound dehiscence 0.59% (7/1180), corneal ulceration caused by suture material 0.25% (3/1180), and wound infection (2/1180). None of the 601 operated dogs developed serious complications related to the surgical technique. CONCLUSIONS: The simplified MCP is a novel technique with a very low complication rate.

Brow rhytidectomy with or without Stades-like procedure for correction of pseudoptosis and trichiasis-entropion of the upper eyelid in Chow Chow and Shar-Pei dogs: A retrospective study of 27 dogs (2019-2022).

PURPOSE: Heavy brows in Chow Chow and Shar-Pei dogs can be associated with pseudoptosis and trichiasis-entropion of the upper eyelids, causing vision impairment and ocular discomfort. This study describes the outcomes of brow rhytidectomy ± Stades-like procedure to address these anatomical abnormalities. METHODS: Retrospective medical records review (2019-2022). RESULTS: Twenty-seven dogs (n = 15 Chow Chow, n = 12 Shar-Peis) were included, aged 1.9 ± 1.5 years (0.5-6.5 years). Presenting complaints included recurrent episodes of ocular inflammation (n = 13, 48.1%), blepharospasm (n = 10, 37.0%), corneal ulcers (n = 8, 29.6%), entropion (n = 6, 22.2%), and impaired vision (n = 4, 14.8%). Brow skin was removed as follows: (i) First incision parallel and 10-15 mm dorsal to upper lid, slightly extending beyond medial/lateral canthi; (ii) second incision forming an arc with its apex 15-35 mm dorsal to the first incision; and (iii) standard two or three layers closure. In 22/27 dogs, a Stades-like procedure was performed by removing a 2-4 mm strip of skin above eyelid margin and leaving it to heal by secondary intention (no sutures). At last recheck (follow-up 354.5 ± 187.8 days), 19/27 dogs (70.4%) had an adequate eyelid conformation, 7/27 dogs (25.9%) were considered under-corrected, and 1/27 dogs (3.7%) was over-corrected. Most owners (81.5%) were satisfied with the surgical results. Most cases (96.3%) had no recurrence of the clinical signs during the entire follow-up period. CONCLUSIONS: Brow rhytidectomy ± Stades-like procedure provide good cosmetic and clinical outcomes in Chow Chow and Shar-Pei dogs, although under correction may occur in severely affected dogs and with advancing time.

Gender-Related Differences in Dry Eye Symptoms Following Involutional Ectropion and Entropion Surgery.

This prospective case-control study investigated gender-related differences in dry eye symptoms following surgery for involutional ectropion and entropion. A total of 109 patients, aged between 65 and 89, were categorized by eyelid condition and gender. Postoperative assessments included the Tear Film Break-Up Time (TBUT) test, Schirmer I test results, corneal and conjunctival staining, eyelid margin characteristics, and scores from the Ocular Surface Disease Index (OSDI) questionnaire. The analysis revealed notable gender-related differences in dry eye manifestations. Initially, men exhibited lower TBUT scores but higher Schirmer test readings compared to women; however, these disparities diminished over time. No significant gender differences were detected in corneal and conjunctival staining, indicating similar levels of ocular surface damage across genders. Males showed significantly higher values in several eyelid margin characteristics (LMI, LMT) at various postoperative time points. According to the OSDI questionnaire, women experienced more severe symptoms of dry eye both pre- and post-operatively, suggesting a greater subjective symptom burden. When comparing surgical outcomes for ectropion and entropion, both conditions showed improvement in eyelid positioning and dry eye symptoms post-surgery. Despite these improvements, women with either condition reported more severe dry eye symptoms compared to men throughout the postoperative period. This study highlights the gender-specific variations in dry eye symptoms following eyelid malformation surgery and emphasizes the importance of adopting gender-sensitive approaches in postoperative care to improve outcomes and ocular health.

The current alternative for ocular surface and anophthalmic socket reconstruction, cryopreserved umbilical amniotic membrane (cUAM).

PURPOSE: This report presents the results of using cryopreserved umbilical amniotic membrane (cUAM) as an alternative mucosal graft for ocular surface reconstruction in cases of anophthalmic socket contracture (ASC), cicatricial entropion (CE), and conjunctival-scleral defects. METHODS: The study included patients who underwent non-commercial implantation of cUAM grafts (prepared by corneal banking methods) for ASC, CE, conjunctival defect, and scleral melting. The main success criteria for this study were the comfortable fitting of the ocular prosthesis in ASC patients, the natural eyelid position in CE patients, and the degree of conjunctivalisation in melting patients. RESULTS: cUAM transplantation was performed in 2 patients who could not use a prosthetic eye due to conjunctival contracture, 2 patients with CE, and 1 patient with conjunctival defect and 1 patient with conjunctival-scleral melting. The primary outcome was achieved in 83.3% (5/6) of patients. In one patient with CE, partial healing was achieved due to the persistence of CE in the medial upper eyelid. CONCLUSIONS: cUAM is a viable alternative to mucosal grafting for reconstructing the bulbar and palpebral conjunctival surface, fornix, and orbit, with reduced donor morbidity and shorter surgical time. Its regenerative ability allows for tissue defect healing and improves cosmetic appearance through epithelialization within weeks.

Lateral canthal reconstruction for the treatment of macroblepharon/diamond eye conformation in dogs.

PURPOSE: To introduce a novel surgical technique for treatment of macroblepharon and diamond eye conformation in dogs. METHODS: Lateral canthal reconstruction was used in dogs with prominent eyelid malformations resulting in ocular surface disease. Lateral canthus was resected and new lateral canthus was created using a two-layer closure. This technique was performed either alone or in combination with additional procedure(s). Additionally, this technique was used to resect lateral canthal dermoid. RESULTS: One hundred and fifty-three eyes of 85 dogs were included in the study. Procedure was done for macroblepharon and/or lateral canthal entropion (149 eyes of 81 dogs) or for lateral canthal dermoid (four eyes of four dogs). Procedure was done either alone (n = 68 eyes) or in combination with additional procedure (n = 85 eyes). Favorable cosmetic outcome and client satisfaction was achieved in all dogs. Good to excellent functional outcome was recorded in all but 6 eyes of 4 dogs, which required additional surgery. Most common complications included slight undercorrection or overcorrection. CONCLUSIONS: Lateral canthal reconstruction is a simple yet effective surgical procedure for macroblepharon and/or lateral canthal entropion. If done early, it prevents development of secondary eyelid malformation ("pagoda defect") in giant breed dogs. If done after severe eyelid malformation has developed, combining this technique with concurrent pagoda resection is recommended to achieve ideal eyelid conformation. None.

Reducing tension step by step in epicanthus and lower eyelid incision for treating cilial entropion in children: A case series analysis.

OBJECTIVE: To evaluate the surgical outcomes of a modified technique for treating congenital cilial entropion in children, which involves reducing tension step by step in the epicanthus and lower eyelid incision. METHODS: The observational group consisted of 153 pediatric patients (81 males and 72 females) who were treated using the modified technique, whereas the control group included 124 patients (68 males and 56 females) who were treated using the rotating suture surgery. All the participants were bilateral. Surgical outcomes were classified as good, fair, or poor, and the recurrence rate, scar condition, inferior eyelid position, and patient satisfaction were also assessed. RESULTS: The mean follow-up period was 9.13 ± 3.50 months (range: 3-14 months) for the observational group and 6.93 ± 4.51 months (range: 3-14 months) for the control group. In the observational group, surgical success with "good" outcomes was achieved in 300 eyes (98.04%), compared to 224 eyes (90.32%) in the control group. No recurrence occurred in the observational group, whereas the recurrence rate in the control group was 4.43%. Postoperative scar formation was mild in the observational group. The average scar score was 1.27 ± 0.96 in the observational group and 2.70 ± 0.99 in the control group, with a statistically significant difference (P < 0.001). Neither overcorrection nor postoperative ectropion was observed in both groups. CONCLUSION: The modified technique effectively corrected medial entropion and trichiasis in the lower eyelid, resulting in stable postoperative outcomes, mild scar formation, quick recovery, flexible eyelid motility, and stable ocular surface. Therefore, it can be widely applied to children with congenital entropion and trichiasis.

Trichiasis removal using dermatological punch: A case report.

Entropion, a common malposition of the eyelid, can lead to trichiasis and corneal damage. This article presents a clinical case in which, following initial surgery to correct entropion, the use of a dermatological punch was chosen to definitively eliminate persistent trichiasis. This relatively unknown yet effective approach proved to be a quick and straightforward alternative with positive outcomes, emphasizing the importance of considering innovative approaches to recurrent challenges in clinical practice.

Feline distichiasis treated with cryoepilation: A retrospective study of 15 cats (27 eyes).

OBJECTIVE: To describe the clinical features of cats diagnosed with distichiasis and report on the outcomes following cryoepilation. ANIMALS STUDIED: Fifteen cats (27 eyes). PROCEDURES: Medical records of domestic cats with distichiasis that underwent a double freeze-thaw cycle with a -80°C cryoprobe applied to the palpebral conjunctiva, with hair then epilated were retrospectively studied. The patient signalment, distichiae locations, concurrent ocular diseases, recurrences, complications, and outcomes were recorded. RESULTS: The mean (std dev) age at the time of diagnosis and treatment was 2.2 years (2.8 years). All (15/15) cats were of the domestic shorthair (DSH) breed. Concurrent ocular findings at the initial examination were observed in 17/27 (63%) eyes, with upper lateral eyelid hypoplasia the most prevalent, present in 9/27 (33.3%) eyes. Recurrence of distichiae occurred in 8/27 (29.6%) eyes. The clinical presentation in the instances of recurrence was judged as asymptomatic and not of a clinical concern in 3/27 (11.1%) eyes, with a second procedure deemed necessary to alleviate symptoms in 5/27 (18.5%) eyes. All eyes treated with a second procedure had no recurrence of distichiae or symptoms. Complications following cryoepilation occurred in 4/27 (14.8%) eyes, with two cats developing bilateral entropion post-procedure. CONCLUSIONS: Treatment of distichiasis in cats utilizing cryoepilation was effective at alleviating symptoms, though some cats needed a second procedure. The development of post-procedural entropion was seen occasionally.

Long-term success rate of entropion surgery is equivalent in juvenile and adult dogs.

OBJECTIVE: To compare long-term outcomes of lower lid entropion surgery performed in juvenile dogs versus adult dogs and evaluate the success rate of temporary tacking procedures in dogs < 1 year of age. ANIMALS: 116 client-owned dogs. METHODS: A retrospective study was performed evaluating dogs younger than 3 years old diagnosed with primary lower lid entropion between 2010 and 2020. Recurrence of entropion following temporary tacking sutures was evaluated. Surgical outcomes were evaluated of entropion surgery in dogs < and > 1 year of age. RESULTS: 44 dogs with entropion (71 eyes) had a temporary tacking procedure. The entropion resolved in 36.6% of eyes, requiring no further therapy. The median age of dogs successfully treated with a temporary tacking procedure was younger than those that failed. Forty-seven dogs (75 eyes) had entropion surgery at maturity, and 52 dogs (79 eyes) were juvenile. Twenty-seven dogs had temporary tacking procedure prior to surgery, accounting for the difference in number. There was no statistically significant difference in the recurrence rate of entropion between eyes of adult (6/75 [8%]) and juvenile dogs (10/79 [12.7%]) following surgery. CLINICAL RELEVANCE: Entropion surgery in juvenile dogs is not associated with a higher risk of recurrence and need not be delayed until dogs are older than 1 year of age.

Comparison of entropion outcome with and without intervention in Romane and Ile de France sheep breeds.

BACKGROUND: Congenital entropion is the most frequent ocular disorder in newborn lambs of certain sheep breeds, which, if not treated, can result in complete blindness and death due to starvation. OBJECTIVES: The aims of this study were to compare the spontaneous healing of entropion in two breeds and assess the outcome of cases with and without therapeutic intervention. METHODS: A total of 158 entropion cases (119 Ile de France and 39 Romane) were investigated, and swab samples were collected from the cornea and conjunctiva of 73 of the affected lambs for bacteriological investigation. In addition, an ocular intervention was carried out in 123 affected animals. RESULTS: The Romane breed developed entropion at an average age of 7 days compared to the Ile de France, which developed it at an average age of 1 day. Likewise, significant differences were found between bilateral and unilateral involvement in both breeds. Meanwhile, 22.1% of cases recovered spontaneously, and the highest rate of spontaneous recovery without intervention was observed in the Romane breed (66%). Bacteria isolated from ocular samples included Staphylococcus spp. (42.5%), Bacillus spp. (21.9%), Trueperella pyogenes (13.7%), Corynebacterium spp. (12.3%) and Escherichia coli (9.6%). CONCLUSIONS: The results of the study showed that the onset time of entropion, bilateral involvement, the severity of the process and the need for re-treatment were higher in the Ile de France breed than in the Romane breed. Likewise, the Romane breed showed a higher degree of spontaneous recovery of entropion.

Outcomes of combined procedures compared to various single techniques for involutional entropion.

BACKGROUND: To describe the outcomes of triangular tarsectomy and limited orbicularis myectomy with lower eyelid retractor plication compared to an everting sutures (ES) technique or lateral tarsal strip (LTS) procedure for the correction of lower eyelid involutional entropion. METHODS: A nonrandomized clinical study was carried out at two tertiary eye hospitals between January 2016 and December 2019. Patients in Group A underwent triangular tarsectomy and limited orbicularis myectomy with lower eyelid retractor plication. Group B had ES, and Group C underwent a LTS procedure. All participants were operated by one surgeon and underwent 1-year follow-up. RESULTS: A total of 78 patients in whom 84 eyelids were affected by lower eyelid involutional entropion were included in the study. The success rate was higher in Group A compared to Group B and Group C (100% vs. 86.7% vs. 95.8%; P < 0.05). Recurrence at a 1-year follow-up was noted in only four (13.3%) eyelids in Group B and one (4.2%) in Group C. However, patient's in Group C experienced a higher frequency of minimal postoperative complications, including short-term pain (100%), tenderness on the lateral canthal area (100%), tightness of the eyelid (91.7%), and ecchymosis (54.2%) compared to Group A. Patients of Group B experienced minimal or no postoperative complications. CONCLUSIONS: Triangular tarsectomy and limited orbicularis myectomy with eyelid retractor plication may be considered the standard procedure for correcting lower eyelid involutional entropion with no recurrence compared to LTS technique or minimally invasive and cost-effective ES procedure.

Horizontal eyelid shortening alone versus combined procedures for the correction of involutional lower eyelid entropion.

BACKGROUND: Conventionally, management of involutional entropion involves correcting both vertical and horizontal laxity, however the optimal surgical approach is debated. OBJECTIVE: To compare the recurrence rate of horizontal lower eyelid shortening alone with combined surgical approaches for correction of involutional lower eyelid entropion. METHODS AND MATERIAL: A retrospective, comparative, consecutive case series of patients undergoing surgery for involutional lower eyelid entropion with both horizontal and vertical laxity. Patients were categorized based on the procedure as: Group 1, horizontal shortening alone, Group 2, horizontal shortening with everting sutures), and Group 3, horizontal shortening with retractor plication. RESULTS: Of the 249 procedures (31 bilateral) performed on 218 patients, 54 (22%) involved horizontal eyelid shortening alone (Group 1), while 80 (32%) had this combined with everting sutures (Group 2), and 115 (46%) with retractor plication (Group 3). The anatomical success rates for Groups 1, 2, and 3 were 93, 94, and 90% (P = 0.69), respectively. Similarly, reported symptom improvements were 94, 93, and 93% for these groups (P = 0.91). After an average follow-up of 15.7 months (median 10; range 6-81), Group 1 (eyelid shortening alone) had a 7% (4/54) recurrence, compared to 8% (16/195) in Groups 2 and 3 (combined procedures) (P = 1.0). Complications were minor, with no significant difference between groups. CONCLUSION: Eyelid shortening alone appears to be as effective as combined techniques for involutional entropion with both horizontal and vertical eyelid laxity. Nevertheless, procedure selection should consider primary pathogenic factors.

Modified Anterior Lamellar Recession for All Grades of Upper Eyelid Trachomatous Cicatricial Entropion.

Purpose: This study aims to assess the combination of anterior lamellar recession (ALR) with blepharoplasty, suprasternal fixation, and internal eyelash bulb extirpation of aberrant lashes posteriorly located in patients with any grade of upper eyelid trachomatous cicatricial entropion. Patients and Methods: We reviewed the clinical data of eighty-six patients (143 eyelids) including age, gender, systemic medical illnesses, and comprehensive ophthalmological assessment. Eyelid evaluation was recorded, including laterality, previous surgical technique used, possible trichiasis etiology, abnormality of the lid margin, tarsal plate consistency (shrinkage or loosening), skin fold overhanging, laxity of the pretarsal skin, margin reflex distance 1 (MRD1), lagophthalmos, and lid retraction. The success rate was assessed at 3, 6, 9, and 12 months postoperative. Results: The success rate was 97.2% in the third month, which decreased significantly to 92.3% in the 6th month and 90.2% in the 9th month (P = 0.01, and 0.001 respectively). In the 9th month, we had fourteen failed cases. All of them were submitted for a second intervention. Three underwent electrolysis, four cases underwent re-internal bulb extirpation, four cases underwent the same procedure, and three cases underwent epilation. The success of the failed cases after the second intervention was significantly associated with the type of reintervention (P = 0.03), in which all of them succeed except two cases that underwent epilation. Kaplan-Meier analysis showed that the mean recurrence time in our study was 6.8 months (95% CI = 5.8-7.7 months). Conclusion: This study showed the combination of ALR with blepharoplasty, suprasternal fixation, and cauterization or internal bulb extirpation of posteriorly located lashes procedure resulted in a high success rate in patients with any form of UCE with no increase in incidence or degree of lagophthalmos associated with UCE.

Case Report: Simultaneous penetrating keratoplasty with autologous simple limbal epithelial transplantation as an alternative to keratoprosthesis.

Introduction and importance: This case report highlights the multidisciplinary approach required to achieve successful anatomical and functional outcomes, in an eye with total limbal stem cell deficiency (LSCD) associated with underlying corneal scarring and thinning. Presentation of case: A 59-year-old gentleman had poor visual recovery in the right eye (RE) following accidental carbide blast, 1-year before presenting to us. The visual acuity was counting fingers and clinical examination revealed cicatricial entropion involving the upper eyelid, total LSCD, corneal scarring with a central descemetocele and cataract in the RE. Prior to ocular surface reconstruction, entropion correction was performed. Three months later, penetrating keratoplasty combined with cataract surgery and intraocular lens implantation (penetrating keratoplasty (PK) triple), with autologous simple limbal epithelial transplantation (SLET) was performed. The visual acuity was 20/100, 18 months after the surgery, with a clear well-epithelized corneal graft and stable ocular surface. Discussion: LSCD is caused by a decrease in the population and /or function of the limbal epithelial stem cells. Limbal stem cell transplantation (LSCT) is warranted in eyes with total LSCD. In eyes with coexisting corneal scarring, LSCT alone may be inadequate to restore the vision. These eyes require simultaneous or sequential lamellar or full-thickness corneal transplantation for visual rehabilitation. Though, the existing literature favors a sequential approach, where LSCT is performed first followed by corneal transplantation, under certain circumstances such as a thin underlying cornea like in our case, corneal transplantation may have to be combined with LSCT to achieve optimal outcomes. Conclusion: Combining autologous SLET with PK can be performed for visual rehabilitation in eyes with unilateral total LSCD and underlying corneal thinning. Corneal and limbal graft survival is prolonged if existing adnexal comorbidities are addressed before any surgical intervention is planned and adequate time interval is allowed for the surface inflammation to subside.

Lower eyelid entropion following transconjunctival orbital fracture repair: Case series and literature review.

Lower eyelid malpositions following transconjunctival repair of the floor and the zygomaticomaxillary complex fractures are rarely observed. The case series includes three patients (mean age, 22 years; 3 males) who developed lower eyelid entropion following orbital fracture repair (two complexes, one isolated type) using titanium mesh (n = 2) or iliac bone grafting (n = 1) through the transconjunctival approach. Entropion repair was attempted with scar release and Jones procedure in one, and posterior lamellar lengthening with mucous membrane graft in two patients. At a median follow-up of 25 months (range, 3-24), two patients had symptomatic relief without any lash globe touch, and one patient had persistent entropion after multiple interventions including failed mucous membrane graft (n = 1), full-thickness blepharotomy with everting sutures (n = 1), and scleral spacer grafting for posterior lamellar lengthening (n = 1). The literature is inconclusive about the association between eyelid malpositioning and any specific implant material, type of fracture, or incision closure technique.

Comparison of postoperative recurrence rates between percutaneous and transconjunctival approaches for involutional entropion.

Lower eyelid entropion is the second most common disease seen after ptosis in oculoplastic outpatients. In this study, we performed percutaneous and transconjunctival shortening of the anterior and posterior layers of the lower eyelid retractor (LER) to treat lower eyelid involutional entropion. This study aimed to examine the recurrence rate and complications of the percutaneous and transconjunctival approaches. This was a retrospective study of procedures conducted from January 2015 to June 2020. The LER shortening was performed for lower eyelid involutional entropion on 103 patients (116 eyelids). From January 2015 to December 2018, LER shortening using the percutaneous approach was implemented; from January 2019 to June 2020, the transconjunctival approach was used to shorten the LER. All patient charts and photographs were retrospectively reviewed. Recurrence occurred in 4 patients (4.3%) in the percutaneous approach. No recurrence was observed in any patient in the transconjunctival approach. Temporary ectropion occurred in 6 patients (7.6%) when the percutaneous approach was used; all cases healed within 3 months after surgery. The study did not reveal any statistically significant difference in recurrence rates between the percutaneous and transconjunctival approaches. We achieved results equal to or better than percutaneous LER shortening by combining transconjunctival LER shortening with horizontal laxity shortening, such as lateral tarsal strip, pentagonal resection, and orbicularis oculi muscle resection. However, it is necessary to be careful about temporary ectropion after surgery when percutaneous LER shortening alone is performed for lower eyelid entropion.

Entrecruzamiento del orbicular para el entropión senil mediante técnica de Martínez-Rodríguez modificada / Orbicularis Crosslinking for Senile Entropion Using the Modified Martinez-Rodríguez Technique

Objetivo: Describir los resultados de la técnica de entrecruzamiento del orbicular, descrita por profesores eméritos del Pando Ferrer, en el entropión senil. Métodos: Se realizó un estudio observacional descriptivo longitudinal retrospectivo con pacientes atendidos en el Instituto Cubano de Oftalmología Ramón Pando Ferrer entre enero del 2021 a junio de 2022. La muestra estuvo constituida por pacientes operados con entropión senil con la técnica de Martínez Rodríguez modificada. Se les realizó examen ocular completo con seguimiento a las 24 h, 7 y 15 días, al mes y a los tres meses posteriores a la cirugía. Las variables utilizadas fueron edad, sexo, lateralidad, tiempo de cirugía y complicaciones. Resultados: La edad media fue de 79,26 años, con predominio del sexo masculino (69,56 por ciento) en 23 pacientes y 26 párpados; siendo 20 casos unilaterales y 3 bilaterales. Se reportó una complicación de hipocorreción (3,84 por ciento) y un tiempo medio de 11,9 minutos. Conclusiones: La técnica descrita es un abordaje efectivo demostrado en la baja frecuencia de complicaciones, sencillo y poco invasivo para entropión senil sin laxitud horizontal grave(AU)

Objective: To describe the results of the orbicularis crosslinking technique, described by emeritus professors from Pando Ferrer institute, in senile entropion. Methods: A retrospective, longitudinal, descriptive and observational study was carried out with patients who received attention at Instituto Cubano de Oftalmología Ramón Pando Ferrer between January 2021 and June 2022. The sample consisted of patients with senile entropion operated on with the modified Martinez-Rodriguez technique. They underwent a complete ocular examination with follow-up at 24 hours, 7 and 15 days, one month and three months after surgery. The used variables were age, sex, laterality, surgery time and complications. Results: The mean age was 79.26 years, with a predominance of the male sex (69.56 percent) in 23 patients and 26 eyelids; there were 20 unilateral cases and 3 bilateral ones. One complication of hypocorrection (3.84 percent) and a mean time of 11.9 minutes were reported. Conclusions: The described technique is an effective approach for senile entropion, demonstrated according to the low frequency of complications, as well as simple and minimally invasive and without severe horizontal laxity(AU)

Mucous membrane grafting for cicatricial entropion repair: review of surgical techniques and outcomes.

Mucous membrane graft (MMG) is used for moderate-to-severe cicatricial entropion repair either in primary or recurrent cases. We conducted a review to comprehensively summarize the various surgical techniques, outcomes, and complications of using MMG for cicatricial entropion. Though the comparison between different techniques is limited by multiple factors like small numbers of cicatricial entgropion patients, variable severity and success criteria across studies, and different underlying cicatricial entropion etiologies, the author has brought forth the nuances of the use of MMG for cicatricial entropion repair along with its outcomes and complications. MMG use in moderate-to-severe cicatricial entropion gives favourable outcomes. The shortened tarsoconjunctiva is lengthened using MMG, which is used either with terminal tarsal rotation or anterior lamellar recession (ALR) or tarsotomy alone. Non-trachomatous entropion has poor outcomes compared to trachomatous entropion. The most common source of MMG is labial or buccal mucosa and the exact size of MMG harvested is variable according to the defect, and very few prefer oversizing the graft by 10-30%. The outcomes of ALR+MMG appear similar to tarsal rotation and MMG for severe cicatricial entropion. The recurrences of trichiasis or entropion can occur for up to one year after surgery, irrespective of the technique used. Factors affecting the outcomes of cicatricial entropion repair are not well known. There is a non-uniformity in data reporting across literature; hence, future studies with details on severity of entropion, ocular surface changes, forniceal depth and ocular surface inflammation, and the degree of dry eye disease would be informative.

Retrobulbar Filling for Enophthalmos Treatment in Dogs: Technique, Description and Computed-Tomographic Evaluation. Preliminary Cadaveric Study.

A new therapeutic approach for enophthalmos may be retrobulbar lipofilling. This study aims to standardize the intraconal filling technique and to evaluate the degree of eyeball displacement by computed tomography (CT). Skull CT was performed on six dog cadavers before and after intraconal injection of two 5% iodinated, viscoelastic solutions, one per eye, using an ultrasound-guided supratemporal approach. The volume to be injected was calculated using formulas for retrobulbar cone anesthesia. After CT, the dogs underwent necropsy and histopathology to evaluate damages that eventually occurred to retrobulbar structures. Eyeball displacement was estimated using two CT-based methods, named M1 and M2. The Wilcoxon signed-rank test revealed no significant difference between the two injected materials in both M1 (p > 0.99), and M2 (lateral p = 0.84 and rostral p = 0.84 displacement). A statistically significant difference was found between the pre- and post-injection group M1 (p = 0.002), M2 (p = 0.004) for the lateral and (p = 0.003) for rostral displacement. Although the slight eyeball displacement, the retrobulbar filling can lead to enophthalmos resolution. Compared to M1, the M2 method has better-defined anatomical landmarks. Further, preclinical in vivo studies are necessary to assess retrobulbar filling efficacy and safety.