Ramapriyadharshini, J (2016) A Study on Different Types of Ectropion and Its Surgical Outcome. Masters thesis, Madras Medical College, Chennai.
|
Text
220300116ramapriyadharshini.pdf Download (23MB) | Preview |
|
|
Text
220300116ramapriyadharshini_abstract.pdf Download (316kB) | Preview |
Abstract
INTRODUCTION: The eyelids are mobile tissue curtains protecting the eyes from injuries. The position of the eyelid against the globe is vital for maintaining the normal function and integrity of the underlying eyeball. Embryologically eyelids arises from two folds of ectoderm and mesoderm at about 8 weeks of gestational age. These two folds fuse by the age of tenth week. By seventh month of gestation they separate again to form eyelids. The lower lid position in relationship to the globe is due to various forces acting on the eyelid by its different anatomic attachments. Superior and posterior traction which keeps the eyelid margin in proper position are the medial and lateral canthal tendons. The lower lid retractors provides an inferior traction. An opposing force to the lower lids is provided in the anterior direction by the globe and various other orbital contents. In case of malfunction of one of the supporting structures or imbalance in the forces acting on the eyelid, the eyelid cannot properly maintain its position in relation to the globe. As a result, inversion or eversion of eyelid margin can occur. AIM OF THE STUDY: To evaluate the etiology and outcome of different surgical modalities applicable in the management of various types of ectropion. METHODS OF EVALUATION: It was a prospective interventional study conducted at Orbit and Oculoplasty department, RIOGOH, Egmore, Chennai for a period of 12 months.25 patients presented with ectropion were included in this study. RESULTS: Out of 25 patients, 19 patients (76%) had involutional ectropion. Among them lateral tarsal strip with medial canthoplasty was done in 10 patients (40%), 9 patients (39%) underwent lateral tarsal strip procedure. Two patients (8%) with mild cicatricial ectropion were subjected to Z Plasty. Of the remaining 4 patients (16%) who underwent scar excision with skin grafting for severe cicatricial ectropion, 1 patient (4%) had a unsatisfactory result with persistent eversion of the eyelid due to insufficient graft uptake. All other 24 patients (96%) had satisfactory surgical outcome outcome in the form of improvement of symptoms like watering, preservation of anatomy (opposition of eyelid to the globe) and better cosmesis. CONCLUSION: `Lateral tarsal strip procedure and medial canthoplasty procedure gives the successful surgical outcome in the form of alleviation of symptoms like watering,restoration of eyelid anatomy,corneal protection in the lateral aspect of the eye and better cosmesis in the management of involutional and paralytic ectropion. Both these procedures are simple with a short learning curve. Z Plasty and skin grafting is the procedure of choice in the management of cicatricial ectropion with local and generalized defect respectively. Thus planning appropriate surgical approach according to the type and pathogenesis of ectropion is the key for successful surgical outcome.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Ectropion,watering of eyes ; inadequate lid closure ; canthal tendon integrity ; lateral tarsal strip procedure ; Z-Plasty ; Skin grafting. |
| Subjects: | MEDICAL > Ophthalmology |
| Depositing User: | Devi S |
| Date Deposited: | 29 Jan 2019 18:28 |
| Last Modified: | 29 Jan 2019 19:46 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/10427 |
Actions (login required)
 |
View Item |
