Quickert Suture Using Nonabsorbable Suture Material for Lower Lid Entropion

PURPOSE: To introduce the modified Quickert suture for lower lid entropion, using nonabsorbable suture material. METHODS: From October, 2011 to June, 2012, a total of 11 patients (12 eyes) with lower lid entropion, in poor general condition or who did not want extensive surgery, were recruited for the present surgery. Three small skin incisions were made at the medial, central, and lateral areas, just below the lower cilia. With double armed 6-0 nylon, each needle was inserted in the inferior conjuctival fornix and the 2 ends of the suture were tied and buried at the point of the skin incision site. Sutures were made at the medial, central and lateral areas. RESULTS: The patients consisted of 4 males and 7 females with an average age of 71.3 +/- 8.4 years (54-82 years). The patients were followed up the patients for an average of 13.9 +/- 2.4 months postoperatively. All patients were satisfied with the outcome, and there were no recurrences. CONCLUSIONS: Quickert suture is a simple and effective method, for correcting lower lid entropion by inducing scar formation with absorbable suture materials, but the effect duration is limited. Because the modified Quickert suture utilizes its own tension with a nonabsorbable suture material, the effect lasts as long as the suture material remains. It is a useful and practicable method for patients, in poor general condition or not wanting extensive surgical procedures.

Quickert Suture Using Nonabsorbable Suture Material for Lower Lid Entropion

PURPOSE: To introduce the modified Quickert suture for lower lid entropion, using nonabsorbable suture material. METHODS: From October, 2011 to June, 2012, a total of 11 patients (12 eyes) with lower lid entropion, in poor general condition or who did not want extensive surgery, were recruited for the present surgery. Three small skin incisions were made at the medial, central, and lateral areas, just below the lower cilia. With double armed 6-0 nylon, each needle was inserted in the inferior conjuctival fornix and the 2 ends of the suture were tied and buried at the point of the skin incision site. Sutures were made at the medial, central and lateral areas. RESULTS: The patients consisted of 4 males and 7 females with an average age of 71.3 +/- 8.4 years (54-82 years). The patients were followed up the patients for an average of 13.9 +/- 2.4 months postoperatively. All patients were satisfied with the outcome, and there were no recurrences. CONCLUSIONS: Quickert suture is a simple and effective method, for correcting lower lid entropion by inducing scar formation with absorbable suture materials, but the effect duration is limited. Because the modified Quickert suture utilizes its own tension with a nonabsorbable suture material, the effect lasts as long as the suture material remains. It is a useful and practicable method for patients, in poor general condition or not wanting extensive surgical procedures.

Clinical Results of Different Surgical Procedures in Correcting Involutional Entropion

PURPOSE: To evaluate the long-term effectiveness of different surgical procedures according to horizontal eyelid laxity in correcting involutional entropion. METHODS: This retrospective study reviewed 104 eyes of 79 patients with involutional lower eyelid entropion who underwent surgical repair. The 62 eyes with horizontal eyelid laxity were classified as group I. In 17 eyes of group I, we performed the lateral tarsal strip procedure alone (group Ia), while in 45 eyes of group I, we performed the lateral tarsal procedure and Quickert suture (group Ib). The 42 eyes without horizontal eyelid laxity were classified as group II. In 13 eyes of group II, we performed a lower eyelid retractor reinsertion procedure only (group IIa), and in 29 eyes of group II, we performed combined lower eyelid retractor reinsertion and orbicularis resection (group IIb). RESULTS: The recurrence rate in these four surgical subsets (group Ia , group Ib, group IIa, group IIb) was 11.7%, 0%, 15.4%, and 6.9%, respectively, with an average follow-up of 11 months. Six recurrent eyelids and two overcorrected eyelids successfully underwent procedures to correct recurrent entropion and ectropion, respectively. CONCLUSIONS: The lateral tarsal strip procedure is an effective approach for achieving long-lasting correction of involutional entropion with horizontal eyelid laxity, whereas the lower eyelid retractor reinsertion procedure is an effective approach for achieving long-lasting correction for involutional entropion without horizontal eyelid laxity. Use of the Quickert suture reduced the need to repeat the lateral tarsal strip procedure and additional orbicularis resection decreased the need to repeat the lower eyelid retractor reinsertion procedure.