Entropion

Abstract: Floppy eyelid syndrome (FES) usually affects middle-aged obese men, presenting as a unilateral or bilateral chronic papillary conjunctivitis. The upper eyelid is lax, floppy, and easily everted. The laterality corresponds to the side the patient sleeps on. An association with obstructive sleep apnea (OSA) has been suggested. A personal series of 17 new cases is presented, and 79 previously reported cases are reviewed to give a detailed description of the syndrome. In addition to the classical presentation, patients may present with upper lid ptosis, lash ptosis or trichiasis, lower lid ectropion or rarely entropion, or corneal complications. Eight patients with FES were investigated for OSA. Twenty other patients with known OSA were examined for FES and other possibly associated ocular features. All eight patients referred for sleep studies were found to have OSA. One of the 20 patients with known OSA was found to have FES, and two had features of early asymptomatic FES. One patient with FES and OSA had normal tension glaucoma. Patients with FES should be considered for sleep studies because of the known morbidity of OSA. Simple screening of patients with OSA may detect FES and avoid late corneal complications that can compromise vision.

Abstract: Part 1 Eyelids - a partial thickness: primary repair secondary contrature tissue loss - superficial tissue loss - deep tissue loss in the preiorbital regions the conjuntiva. Part 2 Eyelids - full thickness: primary and secondary repair reconstruction of the eyelids reconstruction of the upper lid "Switch flap" reconstruction of the upper lid in severe scarring (trachoma), S.Elroy Pereira reconstruction of both eyelids reconstruction of the eyelids in the absense of the eye surgery of the medical canthus surgery of the lateral canthus the lacrical system, Richard A.N.Welham the eyebrows. Part 3 Miscellaneous: the eyesocket, L.Vistnes post-enucleation anopthalmos and microphthalmos orbital wall trauma, Ian T.Jackson enopthalmos, Ian T.Jackson entropion, trichiasis and ectropion, J.R.O.Collin ptosis, Cromwell and C.Beard congenital ptosis - Mullers muscle and the levator antagonists epicanthus, telecanthus, bleparophimosis and related conditions craniofacial malformations involving the orbital region, Ian T.Jackson congenital colobomas exenteration of the orbit techniques for transfer of resurfacing materials.

Abstract: A full-thickness graft of hard palate mucosa was used as the lining tissue for eyelid reconstruction in 11 patients over a 7-year period. An orbicularis musculocutaneous flap supplied cover and support. In all cases the mucosal graft was easily removed, convenient to handle, and took completely. The palate donor site reepithelialized by about 3 weeks postoperative and has remained healed and asymptomatic in all cases. In follow-up averaging 3 years, all the reconstructed lids have retained a stable and comfortable lid margin, with no instance of entropion or irritation. The outstanding virtue of palate mucosa for eyelid reconstruction is that it appears to retain most of its original size and stiffness over the long term and thus in a single layer can serve to replace both tarsus and conjunctiva.

Abstract: Hard palate mucosa grafts are an excellent replacement for tarsus and conjunctiva in eyelid reconstruction. Twenty-five eyelids from 18 patients underwent eyelid reconstruction using hard palate mucosa grafts. Patients were treated for a variety of disorders including postblepharoplasty lower eyelid retraction, cicatricial entropion, eyelid retraction secondary to thyroid eye disease, and lagophthalmos following surgery for paralytic ptosis. Surgical results were evaluated, grafts were measured for postoperative shrinkage, and donor site healing was recorded. Several patients had hard palate biopsy specimens evaluated. One of these patients also had a graft biopsied after it had been in place for 3 months. A review of hard palate anatomy and histology and a discussion of surgical technique are presented.