title: The management of ectropion using the tarsoconjunctival composite graft.
abstract: OBJECTIVE
  To demonstrate the technique, advantages, and results of autogenous tarsal grafts in the treatment of ectropion with lower eyelid retraction.
  
  
  METHODS
  Fourteen patients treated with autogenous tarsal grafts were evaluated. Follow-up ranged from 6 to 30 months (mean follow-up, 10 months).
  
  
  METHODS
  All patients were treated at the University of Kansas Medical Center, Kansas City, December 1990 through June 1993.
  
  
  METHODS
  Of 14 patients with ectropion who were treated with this technique, nine had facial nerve paralysis, three had had previous periorbital trauma resulting in cicatricial ectropion, one patient had orbital and congenital lower lid fibrosis, and one patient had Graves' ophthalmopathy with lower lid retraction.
  
  
  METHODS
  All patients underwent autogenous tarsal grafting. Eleven patients also underwent combined laterocanthal suspension (tarsal tongue technique). Seven patients underwent associated upper lid gold weight loading. One patient underwent a medial canthopexy.
  
  
  RESULTS
  All patients had marked improvement functionally and cosmetically. One patient had slight under-correction. Results have remained stable for over 2 years.
  
  
  CONCLUSIONS
  Autogenous tarsal grafts aid in the long-term stability of lower lid ectropion repair. Autogenous tarsal grafting has distinct advantages over other described techniques. When treating paralytic ectropion, other rehabilitative techniques must be additionally employed.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, University of Kansas Medical Center, Kansas City, USA.
authors.forename: G Y
authors.initials: GY
authors.lastname: Shaw
authors.forename: J
authors.initials: J
authors.lastname: Khan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002356:Cartilage / Q000637:transplantation*; D002648:Child; D002675:Child, Preschool; D003228:Conjunctiva / Q000637:transplantation*; D004483:Ectropion / Q000209:etiology / Q000601:surgery*; D005143:Eyelids / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013524:Surgical Flaps / Q000009:adverse effects / Q000379:methods*