Blepharoplasty in Extensive Lower Eyelid Eversion of Severe III–IV Degree

Purpose. To analyze the efficacy of the lower eyelid eversions surgical treatment.Patients and Methods. We have analyzed the outcomes of treating patients with severe lower eyelid eversion during 2013–2019 — 153 patients, 156 operations. The patients were divided into 4 groups: atonic and paralytic...

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Main Author: I. V. Ivolgina
Format: Article
Language:Russian
Published: Ophthalmology Publishing Group 2021-10-01
Series:Oftalʹmologiâ
Subjects:
Online Access:https://www.ophthalmojournal.com/opht/article/view/1598
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author I. V. Ivolgina
author_facet I. V. Ivolgina
author_sort I. V. Ivolgina
collection DOAJ
description Purpose. To analyze the efficacy of the lower eyelid eversions surgical treatment.Patients and Methods. We have analyzed the outcomes of treating patients with severe lower eyelid eversion during 2013–2019 — 153 patients, 156 operations. The patients were divided into 4 groups: atonic and paralytic eversion (109 eyes), traumatic tearing of the lower eyelid (8 eyes), cicatricial ectropion (28 eyes) and mechanical ectropion (in tumors) of the lower eyelid (11 eyes). The following surgeries were performed: duplicature surgery by Willer; by Kuhnt-Szymanowski; resection of the framework structure of the lower eyelid with fixation to the eyelid ligaments; implantation of various materials based on the orbital margin; sling to the eyelid ligaments; free skin plasty; local flaps; excision of tumors with one-stage reconstructive plastics.Results. Postoperatively the improvement was observed in all cases. The lower eyelid eversion was eliminated. There were no any complications. The efficacy criteria was the level of the eyelid margin height with regards to limbus, absence or reduction of lagophthalmus. “Good” result — symmetrical width of the eyelid fissure, absence of lagophthalmus was achieved in 100 % of cases in groups IA and II, in 28.12 % — in group IB, in 71.43 % — in group III, in 63.63 % — in group IV. “Satisfactory” result — the difference in the eyelid fissure width was 1.0–2.0 mm, absence or reduction of lagophthalmus was achieved in 65.62 % of cases in group IB, in 21.43 % — in group III, in 27.28 % — in group IV. “Unsatisfactory” result — the difference in the eyelid fissure width was more than 2.0 mm, the presence of lagophthalmus was achieved in 6.25 % of cases in group IB, in 7.14 % — in group III, in 3.33 % — in group IV.Conclusions. When operating the lower eyelid eversion it is possible to achieve good result. The pathogenically based combined methods of surgical treatment are the most effective. In case of traumatic tearing of the lower eyelid, we need to restore the lacrimal duct. In cicatricial ectropion it is possible to achieve engraftment of the skin graft, elimination of eversion and lagophthalmus. In mechanical eversion (due to eyelid tumors) it is necessary to perform radioexcision of the neoplasm with a single-stage reconstructive plastic surgery of the eyelid.
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spelling doaj.art-903b06d8f075425993a738a3ecc566ae2023-03-13T09:08:42ZrusOphthalmology Publishing GroupOftalʹmologiâ1816-50952500-08452021-10-0118343344110.18008/1816-5095-2021-3-433-441778Blepharoplasty in Extensive Lower Eyelid Eversion of Severe III–IV DegreeI. V. Ivolgina0Тамбовский филиaл ФГАУ НМИЦ «МНТК “Микрохирургия глaзa” им. академика С.Н. Федоровa» Министерства здравоохранения Российской ФедерацииPurpose. To analyze the efficacy of the lower eyelid eversions surgical treatment.Patients and Methods. We have analyzed the outcomes of treating patients with severe lower eyelid eversion during 2013–2019 — 153 patients, 156 operations. The patients were divided into 4 groups: atonic and paralytic eversion (109 eyes), traumatic tearing of the lower eyelid (8 eyes), cicatricial ectropion (28 eyes) and mechanical ectropion (in tumors) of the lower eyelid (11 eyes). The following surgeries were performed: duplicature surgery by Willer; by Kuhnt-Szymanowski; resection of the framework structure of the lower eyelid with fixation to the eyelid ligaments; implantation of various materials based on the orbital margin; sling to the eyelid ligaments; free skin plasty; local flaps; excision of tumors with one-stage reconstructive plastics.Results. Postoperatively the improvement was observed in all cases. The lower eyelid eversion was eliminated. There were no any complications. The efficacy criteria was the level of the eyelid margin height with regards to limbus, absence or reduction of lagophthalmus. “Good” result — symmetrical width of the eyelid fissure, absence of lagophthalmus was achieved in 100 % of cases in groups IA and II, in 28.12 % — in group IB, in 71.43 % — in group III, in 63.63 % — in group IV. “Satisfactory” result — the difference in the eyelid fissure width was 1.0–2.0 mm, absence or reduction of lagophthalmus was achieved in 65.62 % of cases in group IB, in 21.43 % — in group III, in 27.28 % — in group IV. “Unsatisfactory” result — the difference in the eyelid fissure width was more than 2.0 mm, the presence of lagophthalmus was achieved in 6.25 % of cases in group IB, in 7.14 % — in group III, in 3.33 % — in group IV.Conclusions. When operating the lower eyelid eversion it is possible to achieve good result. The pathogenically based combined methods of surgical treatment are the most effective. In case of traumatic tearing of the lower eyelid, we need to restore the lacrimal duct. In cicatricial ectropion it is possible to achieve engraftment of the skin graft, elimination of eversion and lagophthalmus. In mechanical eversion (due to eyelid tumors) it is necessary to perform radioexcision of the neoplasm with a single-stage reconstructive plastic surgery of the eyelid.https://www.ophthalmojournal.com/opht/article/view/1598офтальмологияблефаропластикавыворот нижнего века
spellingShingle I. V. Ivolgina
Blepharoplasty in Extensive Lower Eyelid Eversion of Severe III–IV Degree
Oftalʹmologiâ
офтальмология
блефаропластика
выворот нижнего века
title Blepharoplasty in Extensive Lower Eyelid Eversion of Severe III–IV Degree
title_full Blepharoplasty in Extensive Lower Eyelid Eversion of Severe III–IV Degree
title_fullStr Blepharoplasty in Extensive Lower Eyelid Eversion of Severe III–IV Degree
title_full_unstemmed Blepharoplasty in Extensive Lower Eyelid Eversion of Severe III–IV Degree
title_short Blepharoplasty in Extensive Lower Eyelid Eversion of Severe III–IV Degree
title_sort blepharoplasty in extensive lower eyelid eversion of severe iii iv degree
topic офтальмология
блефаропластика
выворот нижнего века
url https://www.ophthalmojournal.com/opht/article/view/1598
work_keys_str_mv AT ivivolgina blepharoplastyinextensivelowereyelideversionofsevereiiiivdegree