Lateral tarsal strip surgery a ‘workhorse’ for eyelid malposition
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WAILEA, Hawaii — Lateral tarsal strip surgery can be used to tackle many issues presented in patients with lower eyelid malposition, according to a speaker at Hawaiian Eye/Retina 2024.
“Go into the room with the lights on and talk to the patient with the lights on for 30 seconds,” Eli L. Chang, MD, said. “... You’re going to see so much more stuff.”
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Ectropion malpositions occur when the lids turn outward. Normal symptoms include tearing and ocular irritation.
Addressing floppy eyelid syndrome, Chang explained, can allow physicians to make a huge difference in their patients’ life.
“[Floppy eyelid syndrome] has a high association with sleep apnea,” he said. “ ... Don’t just tell them you’ll put them on drops to stop the tearing. Get them to a sleep specialist and get them tested because you can make a big difference in their life.”
For most cases of ectropion malposition, patients will need a tarsal strip ectropion repair.
Entropion malpositions occur when eyelids are inverted or turned inward. In these cases, ocular surface issues are more urgent than in patients with ectropion malposition. Clinicians can provide temporary relief by giving patients contact lenses, medical tape and, in some cases, Botox (onabotulinumtoxinA, Allergan).
Chang said surgery for these patients generally consists of eyelid tightening as well as retractor reinsertion. The “workhorse” surgery for many eyelid malpositions is the lateral tarsal strip, he explained.
“If you don’t know any surgeries at all on eyelids, and you just want to learn just one surgery that’s going to take care of the vast majority of your problems, just learn the tarsal strip,” Chang said.
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Chang EL. Lower eyelid malposition. Presented at: Hawaiian Eye 2024; Jan. 13-19, 2024; Wailea, Hawaii.
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