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Involutional Lower Eyelid Entropion: Combined Wheeler’s and Wedge Resection of Tarsal Plate


C Olali
V Burton
E Samaila

Abstract

BACKGROUND: Involutional entropion, a common eyelid condition, has different methods of surgical correction and attendant variable recurrence rates, depending to a large degree on the method used.
OBJECTIVE: To describe and evaluate a modified technique of entropion repair where the Wheeler’s method is combined with wedge resection of the tarsal plate.
METHODS: This was a chart review study of 49 patients who had the modified technique carried out to correct their involutional entropion. The technique essentially involves dissecting and separating the lower lid pre-tarsal orbicularis muscle from the tarsal plate, resecting a down-base triangular wedge of the tarsus followed by shortening the orbicularis and
anchoring it to the tarsal plate superiorly.
RESULTS: Over the three and a half-year review period, 54 eyelids of 49 patients underwent the procedure to correct their lower eyelid entropion. Of these, 28(57%) were females and 21(43%) males with a mean age of 73.5 years. The mean follow up period was 30.3 months. One (1.9%) recurrence was recorded in all the cases during the follow-up period.
Complications were minimal.
CONCLUSION: The combined Wheeler and wedge resection of the tarsal plate produces very good post-operative results and can be used in primary involutional entropion or as the procedure of choice if an initial different surgical technique used fails.

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eISSN: 0189-160X