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Long-Term Outcome of Combined Lateral Tarsal Strip With Temporal Permanent Tarsorrhaphy for Correction of Paralytic Ectropion Caused By Facial Nerve Palsy

Kwon, Kye Yoon MD*; Jang, Sun Young MD; Yoon, Jin Sook MD, PhD*

Journal of Craniofacial Surgery: July 2015 - Volume 26 - Issue 5 - p e409–e412
doi: 10.1097/SCS.0000000000001875
Brief Clinical Studies

Paralytic ectropion caused by facial nerve palsy often requires surgical intervention for cornea protection. In this study, the authors intended to investigate the long-term surgical outcome of their surgical technique of correcting paralytic ectropion, which is a combined lateral tarsal strip and minimal temporal permanent tarsorrhaphy. The authors performed a retrospective chart review of patients who underwent paralytic ectropion repair by combined lateral tarsal strip with minimal temporal permanent tarsorrhaphy (5 mm) from January 2010 to December 2012. Patients with at least 1 year of follow-up were included. An analysis of preoperative and postoperative measurements included the extent of lagophthalmos, grade of superficial punctate keratopathy (SPK), and tear break-up time (tBUT). The study included 22 patients and a total of 22 eyes. The lagophthalmos, grade of SPK, and tBUT at both 1 month and 1 year of postoperative follow-up were all significantly improved compared with preoperatively (all P < 0.01). At 1 year after surgery, the mean SPK grade and tBUT were slightly, but not significantly, worse than at 1 month after surgery (P = 0.716 and P = 0.632, retrospectively). Three patients were not satisfied with the aesthetic appearance; however, no patient required additional surgery to enhance eyelid closure because of ectropion recurrence or to reopen the tarsorrhaphy during long-term follow-up. Combined lateral tarsal strip with minimal temporal permanent tarsorrhaphy is a quick, safe, and effective surgical technique for the treatment of lower eyelid paralytic ectropion. It produces minimal cosmetic disfigurement and low morbidity during long-term follow-up.

*Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul

Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Kyunggido, Korea.

Address correspondence and reprint requests to Jin Sook Yoon, Department of Ophthalmology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Korea;. E-mail:

Received 24 July, 2014

Accepted 7 April, 2015

The authors report no conflicts of interest.

© 2015 by Mutaz B. Habal, MD.