Lower eyelid suspension using polypropylene suture for the correction of punctal ectropion.
OBJECTIVE
To evaluate the efficacy and complications of lower eyelid suspension with the modified Safdarjung hospital technique using 5:0 polypropylene suture for punctal ectropion.


METHODS
Prospective case series.


METHODS
Thirty one eyelids in 19 patients with mild and moderate ectropion and all types of laxity including involutional and paralytic were included. All patients underwent lower eyelid suspension with the modified Safdarjung hospital technique. A 5:0 polypropylene suture was passed in the pre-tarsal plane between the attachments of the lateral and medial canthal tendons near their insertion at the orbital rim. Successful outcome was judged by the anatomical restoration of the apposition of the punctum to the globe in the upward gaze and the physiological relief of epiphora. The recurrence of lid laxity, overall lid/globe apposition and complications were also noted.


RESULTS
At 1 year follow up anatomical success was achieved in 28 (90%) patients and functional success noted in 27 (87%) patients. Recurrence of lid laxity was noted in 2 patients. There was a suture exposure in one case and a suture granuloma in another case. The results did not correlate to the degree of ectropion and type of laxity.


CONCLUSIONS
Lower eyelid suspension using 5:0 polypropylene suture is a useful procedure for the treatment of involutional and paralytic punctal ectropion. It is simple and effective with minimal complications. However, the effect on scleral show and the concern related to suture material biodegradation over years needs to be further evaluated.
Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi 110002, India.
Ruchi
R
Goel
Saurabh
S
Kamal
Sonam A
SA
Bodh
Sushil
S
Kumar
Jugal
J
Kishore
K P S
KP
Malik
Madhu
M
Singh
Smriti
S
Bansal
D000328:Adult; D000368:Aged; D001672:Biocompatible Materials / Q000737:chemistry*; D004483:Ectropion / Q000145:classification / Q000601:surgery*; D005143:Eyelids / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000601:surgery; D011126:Polypropylenes / Q000737:chemistry*; D011183:Postoperative Complications; D011446:Prospective Studies; D012008:Recurrence; D013536:Suture Techniques / Q000295:instrumentation; D013537:Sutures; D013710:Tendons / Q000601:surgery; D016896:Treatment Outcome
D001672:Biocompatible Materials; D011126:Polypropylenes
Ectropion; Epiphora; Lid laxity; Lower eyelid suspension; Polypropylene suture