Simple effective surgery for involutional entropion suitable for the general ophthalmologist.
OBJECTIVE
To compare the long-term success, recurrence, and complication rate of involutional entropion surgery using the lateral tarsal strip and everting sutures when performed by surgeons in training (resident or fellow) and specialist oculoplastic surgeons (attending supervising physician).


METHODS
Prospective, interventional, comparative, clinical case series.


METHODS
Adult patients with involutional entropion.


METHODS
Lateral tarsal strip and everting sutures (LTS+ES) by residents, fellows, or attending supervising physician. A minimum of 12 months of postoperative follow-up was required.


METHODS
Patients' symptoms and clinical examination to confirm a normal eyelid position (no entropion or secondary ectropion) at rest and with forced orbicularis contraction with the topical amethocaine (tetracaine) test. This test is described.


RESULTS
Fifty-five consecutive patients, aged 57 to 91 years (mean, 77 years) underwent LTS+ES surgery on 62 eyelids. Surgery was performed by a consultant ophthalmic oculoplastic surgeon (attending supervising physician) in 8 eyelids and by 20 different trainees, residents, and fellows in 54 eyelids. Six patients died (11%) within 6 months of surgery and 2 patients (3.5%) were lost to follow-up, resulting in 47 evaluable patients (54 eyelids). The follow-up period was 12 to 34 months (mean, 18 months). Fifty-three of 54 eyelids (98%) had a successful outcome with no recurrence. The surgery was effective when performed by different grades of surgeon (P>0.4).


CONCLUSIONS
The LTS+ES is a simple operation for the correction of involutional entropion that can be performed effectively by both residents and fellows.
Barnes
J A
JA
Oculoplastic and Orbital Service, Charing Cross Hospital, London, United Kingdom.
Bunce
C
C
Olver
Jane M
JM
D000368:Aged; D000369:Aged, 80 and over; D004502:Education, Medical, Continuing; D004774:Entropion / Q000601:surgery*; D005143:Eyelids / Q000601:surgery*; D006801:Humans; D007396:Internship and Residency; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000193:education*; D009885:Ophthalmology / Q000193:education*; D011183:Postoperative Complications; D011446:Prospective Studies; D013518:Surgery, Plastic / Q000193:education; D013536:Suture Techniques; D016896:Treatment Outcome