Corner Sutures for Entropion
An entropion is an inwardly turned eyelid. The condition occurs primarily as a result of advancing age with consequent weakening of certain eye muscles. The imbalance between eye muscle groups results in the inward turning of the eyelid. This condition most often affects the lower eyelids, but may affect the upper. Corner suture entropion requires 2-3strategically placed sutures which will evert the eyelid. The procedure can be completed under local anesthesia with little if any discomfort.
The SkinnyCorner Sutures for Entropion
- avg. recovery
About the Procedure
One aim of corner sutures is to induce fibrosis and adhesion between the orbicularis and lower lid retractors. Local anesthetic is infiltrated subcutaneously and subconjunctivally along inferior border of tarsus. One needle of a double-armed 4-0, 5-0, or 6-0 suture is passed through the inferior fornix, grasping the inferior retractors, traveling obliquely, through the muscle to exit through the skin of the lower lid at a level slightly higher than the entry level in the fornix side. The second needle of the double-armed suture is then passed through the fornix 3mm adjacent to the first entry point in a similar manner and exiting through skin at a higher site closer to the eyelid margin to invert the eyelid. The sutures are tied tightly on the skin. A total of 2-3 of these sutures are placed in a similar manner in the lateral two-thirds of the eyelid.
The goal of corner sutures for entropion is to tighten lower lid retractors, rotate the eyelid margin anteriorly, and induce fibrotic adhesion between the orbicularis and the lower eyelid retractors to prevent further inward rolling of the eyelid.
After surgery, the eye is covered with dressings for approximately 30 minutes to reduce swelling. The dressing is then removed and replaced with cool packs. Activity is restricted for 2 weeks to prevent bleeding. Clean the eyelids using cotton wool and sterile saline, repeat the application of antibiotic ointment 3 times a day for 2 weeks. Bruising and swelling can take 2-4 weeks to subside. Sleep in an inclined position during this time. Contact lenses should not be worn for a few weeks.
The ideal candidate for corner sutures for entropion has acute entropion, spastic entropion, or early involutional entropion.
Not Recommended For
Corner sutures for entropion are not recommended for candidates with severe entropion who desire long term repair.
Side effects from corner sutures for entropion may include blurred or double vision, corneal abrasion, bleeding, infection, asymmetry, overcorrection, eyelid lumps, and possibility of revision surgery.