title: Lower-eyelid tarsal ectropion repair with the Putterman ptosis clamp for lower-eyelid conjunctival Mueller's muscle resection and lateral tendon tuck.
abstract: OBJECTIVE
  To describe a technique for treatment of lower-eyelid tarsal ectropion using the Putterman ptosis clamp for excision of conjunctiva and Mueller's muscle as an adjunct to the lateral canthal tendon tuck.
  
  
  METHODS
  Retrospective case series. Patients with moderate-to-severe lower-eyelid ectropion underwent lateral canthal tendon tucking followed by eversion of the lower eyelid over a desmarres retractor, separation of the lower-eyelid conjunctiva and Mueller's muscle from the underlying capsulopalpebral fascia, placement of the Putterman ptosis clamp, and resection of the incarcerated tissue followed by closure of the conjunctiva and the lateral canthus.
  
  
  RESULTS
  Six patients and 8 eyes were studied. Of the 8 eyes, 6 (75%) had complete resolution of tarsal ectropion and 2 (25%) had mild residual ectropion at last follow up. All 8 eyes (100%) had symptomatic improvement and 0 patients required re-operation. There were no noted severe adverse events.
  
  
  CONCLUSIONS
  Lower-eyelid conjunctival Mueller's muscle resection using the Putterman ptosis clamp as an adjunct to lateral canthal tendon reinforcement is a safe and effective procedure in the treatment of lower-eyelid tarsal ectropion.
authors.affiliation: Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Department of Ophthalmology and Visual Sciences, Chicago, Illinois, USA.
authors.forename: Ramesh M
authors.initials: RM
authors.lastname: Singa
authors.forename: Vinay K
authors.initials: VK
authors.lastname: Aakalu
authors.forename: Allen M
authors.initials: AM
authors.lastname: Putterman
authors.forename: Gil A
authors.initials: GA
authors.lastname: Epstein
mesh_terms: D000369:Aged, 80 and over; D004483:Ectropion / Q000601:surgery*; D005143:Eyelids / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000295:instrumentation*; D012189:Retrospective Studies; D013536:Suture Techniques; D013710:Tendons / Q000601:surgery*