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Evaluation of outcomes of lower eyelid entropion and ectropion surgical repair

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Woźniak-Roszkowska E., Iljin A., Noszczyk B., Antoszewski B.

Polish Journal of Surgery

2023

vol. 96

issue 2

50-58

Introduction: The imbalance of external and internal forces acting on the lower eyelid can result in entropion and ectropion, both of which cause ocular irritation and loss of proper eye protection. Potential complications of untreated cases include recurrent inflammation of the conjunctiva and cornea, conjunctival neovascularization, corneal abrasion or perforation, and ultimately even loss of vision. Although various surgical techniques are used to address this problem, their long-term outcome and effectiveness are still under discussion. Aim: To evaluate outcomes of surgery for entropion and ectropion, including a modified Wheeler’s method for entropion correction. Methods: A non-comparative study (prospective and retrospective groups) included 100 patients operated on in two university hospitals’ plastic surgery departments for lower eyelid entropion or ectropion, following formal ethics approval. The prospective group included 50 patients assessed preoperatively and at 3 and 12 months postoperatively. The retrospective group was comprised of 50 patients (2012–2018), whose preoperative documentation and clinical examinations were analyzed. The main outcome measures were change between pre- and postoperative patient-reported symptoms (VAS scale), ectropion/entropion grading scale (EGS/EnGS), quality of life (WHOQOL-BREF), and occurrence of complications. Results: The differences in the severity of all symptoms before and after surgery evaluated with the VAS scale were statistically significant in both groups (p <0.05). We observed 6 recurrences (12%) in the prospective group and 9 (18%) in the retrospective group, with minor complications. Very good functional and esthetic postoperative results were confirmed in 70% (79) of the whole group and in 13 patients (81.3%) treated with the modified Wheeler’s method. In the prospective group, the Mann– Whitney U test for dependent variables revealed significant improvement in the somatic, psychological, and environmental domains, with no significant change in the social relationships domain. Conclusions: The results following entropion/ectropion surgery prove the effectiveness of the methods used. Complementing them with the modified Wheeler’s method brought an increase in the number of very good outcomes. Surgery of lower eyelid malposition contributed to reduced symptoms and improved quality of life. The rates of postoperative sequelae were low.

Complications after blepharoplasty: a review of the literature

100%

Guzikowski M., Kowalczyk S., Kokoszka M., Sirek S., Wyględowska-Promieńska D.

Annales Academiae Medicae Silesiensis

2025

vol. 79

133-138

WPROWADZENIE: Blefaroplastyka to zabieg chirurgiczny polegający na korekcie lub rekonstrukcji powiek górnych lub dolnych. Głównym celem wykonywania tych procedur jest zniwelowanie oznak starzenia się występujących w okolicy okołooczodołowej oraz poprawienie wyglądu nieestetycznych powiek. Plastyka powiek znajduje również zastosowanie w korekcji schorzeń o podłożu okulistyczno-funkcjonalnym. Celem niniejszego przeglądu jest opisanie najczęstszych powikłań po blefaroplastyce powiek górnych lub dolnych, analiza przyczyn powikłań oraz zaproponowanie metod zapobiegania im oraz ich korekcji. PRZEGLĄD: Ważne jest zrozumienie, w jaki sposób i dlaczego dochodzi do powikłań po plastyce powiek. Większość powikłań pooperacyjnych należy do jednej z czterech kategorii: (1) niedokładna ocena przedoperacyjna, (2) niewłaściwa technika chirurgiczna, (3) zła ocena sytuacji śródoperacyjnej, (4) powikłania idiopatyczne. Do powikłań towarzyszących tego typu zabiegom należą: krwawienie, infekcje, urazy rogówki, podwójne widzenie, niedomykanie powiek (lagophthalmos), opadanie powieki (ptosis), uszkodzenie gruczołu łzowego, zespół suchego oka, asymetryczna linia załamania powieki, pozostały nadmiar skóry i tkanki podskórnej, deformacje bruzdy powiekowej, canthal webbing oraz oparzenia. WNIOSKI: Blefaroplastyka, mimo że jest jednym z najczęściej wykonywanych zabiegów chirurgii plastycznej na świecie, nie należy do najłatwiejszych procedur. Wiąże się z licznymi powikłaniami, które mogą znacząco wpłynąć na ostateczny wynik operacji, a nawet na jakość życia pacjenta. Znajomość wszystkich możliwych powikłań oraz metod zapobiegania im jest kluczowa dla każdego chirurga, który chce osiągać dobre wyniki pooperacyjne.

INTRODUCTION: Blepharoplasty is a surgical procedure to correct or reconstruct the upper or lower eyelids. The main purpose of performing these surgeries is to correct the signs of aging that occur in the periorbital region and to improve the appearance of unsightly eyelids. Eyelid surgery is also used in the correction of ophthalmic conditions. The purpose of this review is to describe the most common complications after blepharoplasty of the upper or lower eyelids, to analyze the cause of the complications, and to propose methods of prevention and correction. REVIEW: It is important to understand how and why complications occur after eyelid surgery. Most postoperative complications fall into one of four categories: (1) inaccurate preoperative evaluation, (2) improper surgical technique, (3) poor intraoperative assessment, and (4) idiopathic complications. Complications associated with this type of surgery include bleeding, infection, corneal injury, double vision, eyelid regurgitation (lagophthalmos), eyelid drooping (ptosis), lacrimal gland damage, dry eye syndrome, an asymmetric eyelid crease line, residual excess skin and subcutaneous tissue, eyelid furrow deformities, canthal webbing, and burns. CONCLUSIONS: Blepharoplasty, despite being one of the most commonly performed plastic surgery procedures in the world, is not the easiest of procedures to perform. It is associated with a number of complications, which can have a major impact on the end result of the operation or even on the patient’s quality of life. Knowledge of all the complications and how to prevent them is crucial for any surgeon who wants to achieve good postoperative results.

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1 Annales Academiae Medicae Silesiensis

1 Polish Journal of Surgery

1 2025

1 2023

1 Antoszewski B.

1 Guzikowski M.

1 Iljin A.

1 Kokoszka M.

1 Kowalczyk S.

1 Noszczyk B.

1 Sirek S.

1 Woźniak-Roszkowska E.

1 Wyględowska-Promieńska D.

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Evaluation of outcomes of lower eyelid entropion and ectropion surgical repair

Complications after blepharoplasty: a review of the literature