Upper eyelid blepharoplasty, tarsal margin rotation, and posterior lamellar super-advancement for correction of severe upper eyelid cicatricial entropion and dermatochalasis

Abstract

Objective: To report the long-term efficacy and safety of simultaneous correction of upper eyelid cicatricial entropion and dermatochalasis. Method: A retrospective non-comparative chart review of consecutive patients with severe upper eyelid cicatricial entropion and dermatochalasis who underwent surgical correction from July 2012 to July 2014 at a tertiary referral centre by a single surgeon. Results: Twelve eyes of 10 patients aged 80±7 (range, 65-92) years old received upper eyelid blepharoplasty, tarsal margin rotation, and graded posterior lamellar super-advancement. All eyes resumed normal upper eyelid margin position with no recurrence over a mean follow-up of 48.3±18 (range, 9-70) months. Complications including suture granuloma (n=1), transient lagophthalmos (n=1), mild lid notching (n=2) and residual peripheral asymptomatic trichiasis or distichiasis (n=3) were managed conservatively successfully. No patients developed exposure keratopathy after surgery, and the number of lubricants required was statistically significantly reduced (p=0.005). Conclusion: Our pilot study showed that combining upper lid blepharoplasty, tarsal margin rotation and graded posterior lamellar super-advancement is safe and effective in achieving long-term correction of severe upper eyelid cicatricial entropion and dermatochalasis.