Topic: ESOPRS 2021 ePoster sessions
Time: Sep 17, 2021 16:00 Amsterdam, Berlin, Rome, Stockholm, Vienna, 15:00 London
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A Comprehensive Analysis of Lid Malposition Surgery in West Sussex
Author: Rashmi Rao
ePoster Number: 222
Entropion & ectropion repair are the two most common oculoplastic procedures done in the UK. There is a lack of evidence-based literature to guide surgical choice. This study was carried out in a district general hospital in the UK and provides some real world data to aid in decision making. The objective was to analyse our surgical outcomes (both objective and subjective). Surgical techniques were evaluated and the most commonly performed procedure identified. Co-pathologies and risk factors were studied. Follow up periods & recurrence rates were calculated. Adverse outcomes were analysed in those patients who did not stop anti-coagulants.
A retrospective analysis was carried out of case files of all adult patients who underwent entropion and ectropion repair between January 2018 and December 2019. Statistical analysis was done in Microsoft excel
268 case notes were analysed: 123 eyes (93 unilateral & 15 bilateral) underwent entropion correction and 219 eyes (101 unilateral & 59 bilateral) underwent ectropion correction. The mean age of patients in our cohort was 79 years for entropion and 82 years for ectropion. There was male preponderance: 67% of the patients who underwent ectropion correction and 62% who underwent entropion correction were males. 9.1% of ectropion patients had co-existing dermatitis, 10% had previous lesion excision and 13.2% had previous ectropion repair. 15.4% of the entropion patients had previous entropion repair.Lateral tarsal strip (LTS) was the most commonly performed surgery for ectropion (34.24%). The next most common procedure was wedge excision, either as a standalone procedure or combined with medial spindle (22.83%). For entropion, the Quickert procedure (involving full thickness lid shortening and everting sutures) was most commonly performed (36.58%). The next most common procedure was LTS with retractor plication (26%). In eight patients, who underwent entropion correction, anticoagulants could not be stopped and no adverse outcomes were noted. In the ectropion cohort, 28 patients could not stop their anticoagulation medication. 22 of these patients (78.6%) did not have any issues. Considering our elderly population, many of whom are on anticoagulants which cannot always be stopped, we found it to be generally safe.No post-operative complications were noted in 88% of ectropion & 97% of entropion repairs. Most of our patients had their first follow up 2 weeks after surgery. Objective success was 94.3% for entropion and 88.6% for ectropion. Subjectively, 87.8% patients were satisfied after entropion repair and 82.6% were happy after ectropion repair.
The population operated on in our trust was very elderly (6 patients were deceased at time of analysis). Continuing anticoagulants appeared to be quite safe. All surgeries were performed/assisted by Oculoplastic consultants and, despite multiple surgical techniques used, all surgeons addressed the primary pathology. The surgical success rates were comparable to best practice (Moorfield’s core outcome & other published papers) and the complication rate was low
|First name||Last name||Base Hospital / Institution|
|Stephen||Sweetman||University Hospital Sussex NHS Foundation Trust|
|Cornelia||Poitelea||University Hospital Sussex NHS Foundation Trust|
Abstract ID: 21-113