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In cases of paralytic ectropion the slackened skin must not be resected but has to be used for the lifting of the lower eyelid. This aim can be reached by an antidromic skin shifting with an ypsiliform incision or in less difficult cases by a hook-shaped skin flap, who becomes effective as a curb of the lower eyelid by the exchange of the flaps.
Two cases of unilateral ectropion uveae with ipsilateral juvenile glaucoma are reported including one with ipsilateral ptosis. This rare, non progressive anomaly, is characterized by the presence of iris pigment epithelium on the anterior surface of iris stroma, quite often associated with neurofibromatosis, ipsilateral ptosis or Rieger's syndrome. Congenital or juvenile glaucoma is almost systematically associated with the condition and must be evaluated and treated. Pathogeny of the anomaly has to be interpreted keeping in mind the concept of neurocristopathy, i.e. developmental anomalies of neural crest origin tissues.
We present three patients with cicatricial ectropion of the upper and lower lids secondary to herpes zoster. Surgical release of the lid traction, excision of scars, and full thickness skin grafting were performed with satisfactory results.
A 72-year-old female developed a cicatricial ectropion after a chemical face peel, a previously undocumented complication. Surgical correction was successful. The pathological specimen is presented and therapeutic implications are discussed.
The authors describe the surgical procedure employed in a case of bilateral cicatricial ectropion (superior and inferior), occurring during the course of a lamellar icthyosis. Total skin homografts should be applied before the appearance of severe corneal lésions on both eyelids, inferior and then superior. Two factors have to be emphasized: the apparent appearance of rejection of the grafts when the first dressings are made, and the progressive retraction of the homografts which requires repeated graft applications.
The authors presented a case, not yet described in Polish literature, of a rare congenital syndrome of uveal ectropion. It was found in a 3-year child. The clinical course of the disease was typical, with associated consecutive glaucoma.
Congenital ectropion uveae (CEU) is a rare, non progressive anomaly characterised by the presence of iris pigment epithelium on the anterior surface, an anterior iris insertion, dysgenesis of the drainage angle and glaucoma. The condition is characteristically unilateral and rarely hereditary. The current theory of development arrest is discussed. We report three cases with CEU of which two already developed glaucoma. All patients with CEU should be carefully examined periodically to detect glaucoma.
We used the temporofrontal flap to repair eyelid ectropion in 12 patients. The results were satisfactory. The indications, advantages and disadvantages, and the points for attention of this operation method were discussed. Experiences and lessons were summarized in this article.
We report on a child, born to a consanguineous parents, who presented with a multiple congenital anomalies (MCA) pattern consisting of severe hypertrichosis, macrostomia, ectropion, and atrophic skin. To our knowledge this is the third case with this combination of defects. The two previous cases were reported by Barber et al. [Syndrome Identification VIII(1):6-9, 1982], and David et al. [Am J Med Genet 41:192-195, 1991].
Two case reports are presented where a unilateral uveal ectropion was associated with congenital and late infantile glaucoma. Ipsilateral to the anterior segment anomaly a dysgenetic angle was found to be the basis of the glaucomatous process. The clinical implication that when such an iris malformation is found in a young child the possibility of glaucoma must be considered is discussed in detail.
Another method for repair of anal ectropion is reported. Two triangular island flaps, deeply based, are advanced medially to cover the excised area, thus resurfacing the anal canal with normal skin. The technique is recommended because of its simplicity, reliability, and satisfactory results.
A V-Y advancement flap modified for anorectal use in reconstructive surgery for anal ectropion is described. The underlying external sphincter serves a dual function as the pivotal point for flap advancement and as the vascular pedicle to the dermal-subdermal plexus supplying the flap. This ensures viability and restores function to the newly created anus.
A technique is described that has proven most effective in correction of postoperative anal stenosis. A modification of this technique also has proven effective in the treatment of symptomatic anal mucosal ectropion--a condition marked by pruritus and perianal soilage from mucosal weeping, usually associated with the Whitehead hemorrhoidectomy. The design of the flap allows primary closure of the donor site and tension-free flap inset with a robust flap blood supply.
Seven cases of severe segmented uveal ectropion are presented. This is a color change of the iris which appears to be caused by pigment eipthelium being pulled from the pupillary margin to the footplates under a Tennant or Mark VIII anterior chamber lens. It was found in 1-2% of cases followed by the author for at least two to three years after lens implant. All eyes have poorly reactive pupils but seemingly well-fitting IOLs and good visual acuity to date. An hypothesis for its pathophysiology is presented which promotes ischemic atrophy with subsequent fibrosis of the iris as the involved mechanisms.
Rotation advancement is a well-known technique in cleft lip repair. This procedure corrects lip length and abnormal muscle insertion, and allows for accurate approximation of lip structures. It is a widely accepted standard of practice for congenital harelip repair that teaches fundamental principles of reconstructive surgery. An innovation is presented in which this procedure is used to correct a traumatic lip ectropion. The anatomic design is identical to a congenital cleft lip repair. The benefits of this approach are discussed in an interesting patient report.
PURPOSE: To verify whether the tarsal strip procedure improves epiphora of patients with eyelid laxity but no ectropion. METHODS: A retrospective study was done with a sample of epiphora patients with lax eyelids in normal position and no nasolacrimal obstruction who were operated on with the tarsal strip technique. Fourteen lower eyelids, in 11 patients, were included in the study. RESULTS: Epiphora in ten eyes (71.4%) completely or significantly improved after a follow-up of three months. Eyelid laxity disappeared in all cases. CONCLUSION: In patients with epiphora, lax eyelids and patent lacrimal ducts, the tarsal strip procedure can significantly improve epiphora in most cases. As laxity ceased to exist in all eyelids, an assumption can be made that in some of the failures there may be other causes, concomitant with eyelid laxity, to explain perseverance of epiphora.
Thirty patients in fertile age affected by ectropion were treated with Polydeoxyribonucleotide (PDRN) (*) vaginal suppositories for 24 days. No other local or general therapy was allowed. The following parameters were evaluated: local symptomatology, tolerability and compliance, vaginal cytology, colposcopic examination, bioptic sampling of affected area prior to and after treatment, and local immune response. The results show the efficacy of PDRN. In fact, after the treatment: reduction of subjective symptomatology with decrease of average score for each symptom; excellent or good tolerability and acceptability; reduced inflammation; increased iodine-dark areas; reestablishment of normal balance in T- and B-lymphocytic populations have been found.
Twenty outpatients, aged 18-45 yrs, with cervical ectropion have been treated with vaginal suppositories of PDRN (a placental derivate). The drug has been given randomly in two preparations of 5 g and 10 g, however both containing the same amount of the active component (5 mg). The results show the effectiveness of the eutrophic and antiphlogistic action of both preparations, with a remarkable reduction of the leukorrhea. The patients preferred the vaginal suppositories of 5g both for the greater maniability and for the smaller vaginal discharge after the administration. The reduction of the excipients in the new vaginal tablets, besides improving the compliance of patients, brings about a longer contact of the drug with the vaginal walls, hence a better bioavailability of the active principle.