Anterior lamellar deficit ectropion management

Area of Science:

• Ophthalmology
• Oculoplastic Surgery
• Reconstructive Surgery

Background:

• Lower eyelid cicatricial ectropion can result from actinic damage, tumor resection, trauma, or prior eyelid surgery.
• Anterior lamellar deficit, often without overt scarring, is a key factor in ectropion development and recurrence.
• Effective correction requires addressing both horizontal laxity and anterior lamellar deficit.

Purpose of the Study:

• To evaluate the outcomes of modified Bick's procedure (MBP) combined with monopedicle myocutaneous flap (MMCF) or full-thickness skin grafting (FTSG) for lower eyelid cicatricial ectropion.
• To compare the efficacy of MBP + MMCF versus MBP + FTSG in correcting ectropion.

Main Methods:

• Retrospective review of patient case notes for cicatricial ectropion repair between 2012 and 2016.
• Analysis of patient demographics, clinical features, surgical techniques (MBP + MMCF or MBP + FTSG), and outcomes.
• Assessment of anatomical success, cosmesis, functional success, and recurrence rates at follow-up.

Main Results:

• Twenty-four eyelids in 21 patients with lower eyelid cicatricial ectropion were treated.
• High rates of anatomical (92%) and functional (87%) success were achieved.
• No statistically significant difference in success rates was observed between MBP + FTSG and MBP + MMCF groups; no recurrences were noted.

Conclusions:

• Modified Bick's procedure (MBP) combined with either FTSG or MMCF is a safe and effective treatment for lower eyelid cicatricial ectropion.
• Addressing anterior lamellar deficit is crucial for minimizing early failure and recurrence.
• The combined MBP approach offers a low early recurrence rate for this condition.