Central lower eyelid thinning with trichiasis: characterization and management of a unique subset of entropion in elderly patients

Ophthalmic Plastic and Reconstructive Surgery
David M Mills, Dale R Meyer

Abstract

To characterize the clinical and pathologic features of central lower eyelid thinning with trichiasis and discuss the management of this unique subset of entropion in elderly patients. Retrospective study of patients with central lower eyelid thinning with trichiasis who presented between July 1996 and March 2006. Evaluation of management, including surgical intervention, using a modified Quickert "4-snip" block excision combined with lower eyelid retractor plication. Forty-one lower eyelids in 25 patients (22 men, 3 women; age range, 65-92 years; mean age, 79.6 +/- 6.6 years). All lower eyelids had medialization of the lateral eyelashes progressing posteriorly to frank trichiasis in the thinnest central zone. Seventeen patients (68%) had blepharitis. Twenty lower eyelids (48.8%) were refractory to initial treatment or presented with more severe disease and required incisional surgery; 16 of these were considered to have a successful postoperative outcome. Pathology reports from the specimens obtained frequently revealed the absence of meibomian glands, subconjunctival fibrosis, and tarsal scarring. Central lower eyelid thinning with trichiasis is a distinct subset of entropion in elderly patients. Its management differs from t...Continue Reading

References

Jun 1, 1978·Archives of Ophthalmology·J R Collin, J E Rathbun
Jan 1, 1990·Ophthalmic Plastic and Reconstructive Surgery·S RosenbergA M Henick
Jan 1, 1988·The British Journal of Ophthalmology·K Barber, T Dabbs
Oct 1, 1972·Archives of Ophthalmology·A S Markovits, M H Quickert
Oct 1, 1994·The British Journal of Ophthalmology·M J Elder, W Bernauer
Apr 26, 2001·Ophthalmology·T CookR K Dortzbach
Jul 13, 2002·Annals of the New York Academy of Sciences·David A SullivanM Reza Dana

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Citations

Apr 29, 2008·Ophthalmology·Bijan BeigiRachna Murthy
Jun 1, 2018·Ophthalmic Plastic and Reconstructive Surgery·Edith R ReshefMichael K Yoon
Jan 27, 2018·Ophthalmic Plastic and Reconstructive Surgery·Antonio A V CruzPatricia M S Akaishi
Jun 9, 2016·Surgical Neurology International·Nancy Ellen Epstein
Jul 30, 2014·Ophthalmic Plastic and Reconstructive Surgery·Bülent Yazici

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