Issue: January 2017
January 14, 2017
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Lateral tarsal strip surgery common for correcting ectropion

Issue: January 2017
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KOLOA, Hawaii — Every ectropion case is different and there are a variety of corrective surgical techniques, but the most traditional approach is lateral tarsal strip surgery, a speaker here.

“If most of your problem is that lower lid, then you’ll want to horizontally shorten that. This is probably the most traditional approach, to do a lateral tarsal strip and tighten it. It’s like tightening a clothesline that has too many clothes hung on it,” Wendy W. Lee, MD, said at Hawaiian Eye 2017.

Wendy W. Lee

Wendy W. Lee

In cases of ectropion, “The lid is not well-closed to the globe, so you get tearing, foreign body sensation, exposure and conjunctival inflammation,” Lee said. The most common type is involutional ectropion, caused by disinsertion of the lower lid retractors and horizontal laxity of the lower lid, which stretches the lateral canthal tendon.

Lee’s surgical approach starts preoperatively with having the patient discontinue all blood thinners as a precaution against orbital hemorrhage, which is rare but serious.

“Theoretically you can get orbital hemorrhage because you are operating down into that orbit where you’re getting toward the orbital rim. So, I think it’s important to have the patient stop their blood thinners 2 weeks before if you can, and then no heavy lifting, bending or straining afterward,” she said. by Patricia Nale, ELS

 

Reference:

Lee WW. Ectropion and entropion: Getting the lid in the right position. Presented at: Hawaiian Eye; Jan. 14-20, 2017; Koloa, Hawaii.

Disclosure: Lee reports no relevant financial disclosures.