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Ectropion (outturned eyelid) repair
An ectropion is an outwardly turned (everted) eyelid. The condition most often is associated with aging, though it may also occur congenitally, as a result of scarring or other surgeries, or secondary to facial nerve paralysis (’Bells palsy). If not repaired, the condition may lead to thickening of the mucosal surface on the inside of the eyelid (conjunctiva) with consequent inflammation of and danger to the health of the eye itself.
The best method of repair for an ectropion often depends on the underlying cause. In the involutional type of ectropion (associated with aging), most surgeons elect to shorten and tighten the lower lid, thereby resolving the outwardly turned lid. This typically is completed with an incision of the skin at the lateral corner of the eye. The surgeon then excises a small segment of the lateral aspect of the lower eyelid, and subsequently reconnects the eyelid to underlying tissues and the upper eyelid.
Usually only a few stitches are placed in the skin at the lateral corner of the eye, and these are often removed 7 to 14 days later. There is typically almost immediate resolution of the condition. Most patients have little if any discomfort with the procedure. There may be mild bruising and swelling following the procedure. This should resolve within about two weeks.
Ectropion which occurs as a result of scarring (cicatricial ectropion) is most likely to follow another surgical procedure of the face or eyelids, especially excision of skin lesions such as skin cancers. This type of ectropion repair often requires skin grafting. The donor site for the skin graft is most often taken from the patient’s upper eyelid or from behind the ear. The skin from these sites will most closely match that of the patient’s lower eyelid skin. Both the donor site for the graft and the surgical site will usually heal nicely within two weeks following the surgery.
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