Entropion repair refers to an operation that fixes inward folding of eyelids. It addresses entropion effects such as light sensitivity, eye redness, pain, and damaged vision. These are due to the constant brushing of eyelashes against the cornea, which subsequently causes discomfort. Inward folding of the eyelids may result from previous eye surgery, muscle weakness, birth deformities, or an infection. It is dominant among the elderly.
Entropion is divided into four types namely, spastic, involutional, cicatricial, and congenital. It commonly affects the lower eyelid and can either be unilateral or bilateral. Although there's an alternative to surgery, entropion repair is the most preferred corrective method since the outcome is long term.
Also Known As
- Entropion reconstruction
- Entropion surgery
Preparation & Expectation Before Surgery
The patient may have an assessment session with the doctor to discuss various issues such as any ongoing medication, as well as previous or present conditions. In instances of diabetes, the patient may be instructed not to eat before surgery. Consequently, this will prompt changes in the number of drugs they are to consume.
The incisions during surgery may cause blood flow. It would therefore be necessary for the patient to halt medication with anticoagulant properties before surgery, temporarily. The operation which involves the use of local anesthesia, may require comfortable clothing from the patient. They may also need to have a light meal before surgery.
After surgery, a bandage will likely be used to patch the eye area. Therefore, the patient would need to arrange for someone to drive them home or help in some home activities in the recovery process.
Types, Purpose & Procedure
Entropion surgery is a short process that can be done by an oculoplastic surgeon or an ophthalmologist. A well-trained nurse will participate in monitoring the patient. Exclusive of children, the process involves the use of local anesthesia to numb the eyelids.
The doctor first administers anesthetic drops in the patient's eye, followed by a face clean up with a sterilized cloth. S/he then identifies the skin area to be removed before numbing the eyelid for surgery. Numbing ensures no feeling of pain during the process.
Surgery may involve removing a small part of the eyelid to make firm the muscles around the area. Where the malpositioning arises from previous surgery, skin grafting may be done to realign the eyelid. A variety of surgical procedures are available for entropion reconstruction. They include:
- Sutures - The doctor will stitch across the eyelid to inhibit upward movement of preseptal muscles. Additionally, s/he will pass an everting suture to tighten lower eyelid retractors.
- Jones procedure - Patients experiencing a recurrence of entropion undergo this procedure. It entails making an incision on the skin of the lid for accessibility. Deep stitching follows to tighten the muscles opening the lid.
- Quicker procedure - The surgeon makes a small cut at the eyelid corner, and removes a piece of skin. The eyelid opening muscles are mechanically held secure, then the stitching of the cut area follows to hold firm the lid.
- Wies procedure - It involves the transverse splitting of the eyelid from which fibrous tissue is obtained. The membrane prevents preseptal muscles from moving upwards. An everting stitch follows to shorten retractor muscles.
Risks, Side Effects & Complications
Entropion repair is a safe procedure. Yet like other medical operations, the patient may be prone to risks such as:
- Eye swelling
The patient may experience eyelid pain, discomfort, blurry vision, numbness as side effects of the surgery. In addition, entropion may recur and this may lead to a possibility of another surgery.
Aftercare, Recovery & Outcome
Enough rest and the use of painkillers can help subside any pain experienced after surgery. Cool compresses followed by warm ones in the first two days can help ease swelling and discomfort.
To reduce the chances of infection and accelerate the healing process, the doctor may prescribe an antibiotic ointment. The doctor will likely recommend avoidance of smoking and any medication that may result in increased bleeding.
The use of contact lenses may not be possible for a while due to blurry vision, which should subside in a few days. In case of severe eye redness, pain, discharge, or worsened vision, the patient should seek medical attention.
Entropion recovery may take approximately two weeks in most patients. Except for recurrence in some patients, the surgery provides long term results. Thus, it boosts confidence, improves vision and appearance.