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KMID : 0602919950010010124
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Journal of the Korean Society of Aesthetic Plastic Surgery
1995 Volume.1 No. 1 p.124 ~ p.133
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The Correction of Entropion Using Skin-Tarsal Fixation with Epicanthoplasty
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박대환
장경수/황동하/한동길/안기영
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Abstract
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Entropion is an inward turning of the eyelid margin and contact of the lashes against the cornea ad can be classified as congenital or acquired. Congenital entropion rarely occurs as an isolated phenomenon but it is usually secondary to
epiblepharon and
epicanthus.
The simple excision of the skin and orbicularis oculi muscle is not sufficient for correcting of the entropion secondary to epiblepharon and epicanthus. It needs the skin-tarsal fixation and the epicanthoplasty. We use not only the excision of
the
skin
and orbicularis oculi muscle but also skin-tarsal fixation and epicanthoplasty. The standard double fold making procedure can evert the eyelash in the upper eyelid but we find that the routine double fold making procedure is not enough for
complete
correction of the entropion. The design of incision of author's method is 2-3mm lower than standard double fold making incision because it may bring more tension on the eyelash and can evert the eyelash completely and can cure entropion. We did
epicanthoplasty, if needed, to correct epicanthal component of an epiblepharon and the epicanthus tarsalis because epicanthus or epiblepharon is also indirect cause of entropion. In the upper lid, an incision is made in the upper eyelid about
4-6mm
above the ciliary margin in adult and about 3-4mm above ciliary margin in children. Excess skin with strip of orbicularis muscle is excised an tight skin-tarsal fixation was done with four buried suteres of 7-0 white nylon. Epicanthoplasty using
Uchida
method and Z-plasty is also performed. A similar method is used in the lower eyelid by incision at 2-3mm below the ciliary margin.
21patients underwent the correction of entropion secondary to epiblepharon by excess skin-muscle excision and skin-tarsal fixation from April of 1991 to January of 1995. 12 patients underwent epicanthoplasty. 15 patients had entropion of upper
lid
and 9
patients were adult. The follow-up period was from 3 months to 36 months. Almost all patient have satisfactory result but 2cases of lower lid entropion have recurrence. We would like to say that our skin-tarsal fixation with epicanthoplasty
technique
can correct entropion completely and has better result than conventional technique.
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KEYWORD
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