Antonio A V Cruz1, Stefania B Diniz2, Juliana A Guimarães3, Roque L Souza3, Alicia Galindo-Ferreiro4, Lilyan M F Araujo5, Sheila A P Cecchetti6, Ana Estela B SanťAnna7. 1. Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, Hospital das Clínicas de Ribeirão Preto-CAMPUS, University of São Paulo, Av Bandeirantes 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil. aavecruz.fmrp@gmail.com. 2. Department of Ophthalmology, Orbital and Ophthalmic Plastic Surgery, Instituto Hospital de Base Do Distrito Federal, Brasília, DF, Brazil. 3. Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, Hospital das Clínicas de Ribeirão Preto-CAMPUS, University of São Paulo, Av Bandeirantes 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil. 4. Department of Ophthalmology, Rio Hortega University Hospital, Valladolid, Spain. 5. Hospital de Olhos Francisco Vilar, Teresina, PI, Brazil. 6. Irecê, Bahia, Brazil. 7. Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo - UNIFESP, Sao Paulo, SP, Brazil.
Abstract
PURPOSE: To assess the clinical characteristics of tarsal buckling after ptosis correction and its management with margin rotation techniques. METHODS: Multicenter retrospective review of ten patients who developed upper eyelid entropion following ptosis correction. In all cases the tarsal deformity was corrected with margin rotational procedures with either a lid crease anterior approach or a traditional posterior approach. Data collection included patient demographics, type of ptosis surgery, and photographic documentation of the affected eyelids. RESULTS: Entropion occurred after a variety of different ptosis surgery techniques, including frontalis sling, levator advancement and supramaximal levator resection. A horizontal tarsal fold was detected in all eyelids, being in the upper third of the tarsus in 70% and in the central tarsus in 20% of the cases. Tarsal buckling was corrected in all cases with rotational surgery, with nine cases being operated through an anterior lid crease approach and 1, through the traditional posterior approach. The most reported complication was minimal residual ptosis. CONCLUSION: Tarsal buckling following ptosis surgery is associated with folds located in the upper part of the tarsus. Margin rotation techniques are effective in restoring the natural position of the eyelid margin in these cases.
PURPOSE: To assess the clinical characteristics of tarsal buckling after ptosis correction and its management with margin rotation techniques. METHODS: Multicenter retrospective review of ten patients who developed upper eyelid entropion following ptosis correction. In all cases the tarsal deformity was corrected with margin rotational procedures with either a lid crease anterior approach or a traditional posterior approach. Data collection included patient demographics, type of ptosis surgery, and photographic documentation of the affected eyelids. RESULTS: Entropion occurred after a variety of different ptosis surgery techniques, including frontalis sling, levator advancement and supramaximal levator resection. A horizontal tarsal fold was detected in all eyelids, being in the upper third of the tarsus in 70% and in the central tarsus in 20% of the cases. Tarsal buckling was corrected in all cases with rotational surgery, with nine cases being operated through an anterior lid crease approach and 1, through the traditional posterior approach. The most reported complication was minimal residual ptosis. CONCLUSION: Tarsal buckling following ptosis surgery is associated with folds located in the upper part of the tarsus. Margin rotation techniques are effective in restoring the natural position of the eyelid margin in these cases.
Authors: Antonio Augusto Velasco E Cruz; Patricia M S Akaishi; Mohammed Al-Dufaileej; Alicia Galindo-Ferreiro Journal: Arq Bras Oftalmol Date: 2015 Nov-Dec Impact factor: 0.872