International Scientific Surgical Association
Первая международная дистанционная
научно-практическая конференция
"Новые технологии в медицине - 2004"
P.K.Sodhi1, L.Verma2, R.M.Pandey3, S.K.Ratan4
TO EVALUATE THE EFFICACY OF MODIFIED MEDIAL CANTHAL TENDON PLICATION TECHNIQUE FOR TREATING LAXITY OF MEDIAL END OF LOWER EYELID
1Department of Ophthalmology, Safdarjung Hospital,
2New Delhi Centre For Sight,
3Department of Biostatistics, All India Institute of Medical Sciences,
4Department of Paediatric Surgery, Safdarjung Hospital,
New Delhi, India
Abstract
Purpose: The purpose of this study was to evaluate the efficacy of modified medial canthal tendon (MCT) plication technique for correcting the laxity of medial end of lower eyelid.
Materials and Methods: 21 eyes (11 patients), including 9 males and 2 females, in the age range of 31-80 (56.716.1) years, having laxity of medial end of lower lid of varying degree were enrolled in this study. These patients presented to us with ocular complaints of watering, recurrent redness, photophobia and foreign body sensation. After grading the amount of lower lid laxity, MCT plication was done for correcting it. In patients in whom laxity was associated with ectropion of lower lid, the severity of lower lid ectropion was also graded. In patients with ectropion of Grade II or more, additional procedures for correcting this were done before undertaking MCT plication. The patients were followed up till six months post operatively and assessed for correction of laxity, recurrence of symptoms and complications of MCT plication.
Results: 21 eyes (11 patients), including 9 males and 2 females, in the age range of 31-80 (56.716.1) years, having laxity of medial end of lower lid were enrolled into this study. 12 (57.14%) eyes had Grade I, 9 (42.86%) eyes had Grade II and none had Grade III laxity of lower lid. 12 eyes had laxity restricted to medial end and 9 eyes had laxity of entire length of lower lid. Among the 21 eyes, 4 (22.22%) eyes had Grade I, 11 (61.11%) eyes had Grade II, 6 (16.6%) eyes had Grade III and none had Grade IV ectropion. In these eyes additional procedure like Zieglers cauterization (11 eyes), excision of diamond shaped segment of tarso- conjunctiva from medial side of lower lid (7 eyes), and lazy T (6 eyes) had to be done. In 1 eye, the medial canthus was anchored to the MCT and this patient had a poor apposition of lower lid to the globe. Hence, in the remaining 20 eyes, the medial canthus was anchored to the orbital periostuem.
The mean change in the eyelid length from preoperative status (32.573.36) to the post operative status (30.02.90) was 2.57mm and was statistically significant (t=17.42; p=0.0). An overriding of lower lid was seen in 2 (9.52%) eyes, and a remnant of gap between lower lid and globe was noticed in 15 (71.42%) eyes. Three (14.28%) eyes had recurrence of epiphora, two (9.52%) eyes had a recurrence of redness, one (4.76%) eye had a recurrence of photophobia and none had a recurrence of foreign body sensation.
Conclusions: MCT plication is an
easy, effective and quick procedure for correcting laxity of lower lid
which is restricted predominantly to the medial end. A correct
identification of anatomical landmarks and appropriate tension of
sutures passed is vital for attaining proper apposition of the lower lid
with the globe.
Key
words:
Lower lid laxity, Lower lid ectropion, Medial canthal tendon plication,
Medial canthal tendon .
Sodhi P.K., Verma L., Pandey R.M., Ratan S.K. TO EVALUATE THE EFFICACY OF MODIFIED MEDIAL CANTHAL TENDON PLICATION TECHNIQUE FOR TREATING LAXITY OF MEDIAL END OF LOWER EYELID // Новые технологии в медицине: Сб. докл. Первой международной дистанционной науч.-практ. конф., Санкт-Петербург, 15-30 марта 2004 г. СПб, 2004. С. 51-52
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