Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Sep;8(3):397-406.
doi: 10.1007/s40123-019-0189-3. Epub 2019 May 24.

Randomized Controlled Trial Comparing Everting Sutures with a Lateral Tarsal Strip for Involutional Lower Eyelid Entropion

Elias A Nakos  1 , Konstadinos G Boboridis  2 , Angeliki A Kakavouti-Doudou  3 , Diamantis D Almaliotis  4 , Christos E Sioulis  5 , Vasileios E Karampatakis  4
Affiliations

Randomized Controlled Trial Comparing Everting Sutures with a Lateral Tarsal Strip for Involutional Lower Eyelid Entropion

Elias A Nakos et al. Ophthalmol Ther. 2019 Sep.

Abstract

Introduction: To compare the anatomical and functional outcome and changes in the quality of life (QoL) over time of the lateral tarsal strip (LTS) versus the Quickert everting sutures (ES) for the repair of primary involutional lower eyelid entropion.

Methods: Forty-five patients (54 eyes) with primary involutional lower eyelid entropion were recruited in a prospective randomized clinical trial over 3-year period. Twenty-six eyes were randomized to the LTS technique and 28 to the ES procedure. Primary outcome was the anatomical correction of the eyelid at the final assessment in 1 year. Secondary outcomes were function and symptoms assessment with a QoL questionnaire at 6 months. Fisher's exact test was used for the statistical analysis of success rate and gender study and Mann-Whitney U test and logistic regression analysis were used for age study. The Wilcoxon and Mann-Whitney U tests were used for the analysis of the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25).

Results: At the 6-month follow-up, 25 eyes (96.2%) of the LTS group and 20 (71.4%) of the ES group had favorable outcome (P = 0.025). There were one and eight eyes, respectively, with early recurrence. At the final 12-month evaluation, 23 eyes (88.5%) in the LTS group and 16 eyes (57.1%) in the ES group were successful. Three (11.5%) and 12 (42.9%) eyes respectively showed postoperative recurrence. There was a statistically significant difference between the two groups (P = 0.015) for the primary outcome, whereas age and gender did not influence success. The NEI VFQ-25 showed statistically significant subjective improvement from baseline in most categories of the QoL. No significant difference between the two procedures was detected at 6 months.

Conclusion: This study suggests that the LTS procedure has a superior surgical success rate and reduction of symptoms compared with the ES for the repair of involutional lower eyelid entropion. Both procedures showed similar improvement of the postoperative QoL.

Trial registration: International Clinical Trials Registry Platform identifier: ACTRN12616000620426.

Keywords: Everting sutures; Eyelid; Involutional entropion; Lateral tarsal strip; Quickert; RCT.

PubMed Disclaimer

Conflict of interest statement

Elias A. Nakos, Konstadinos G. Boboridis, Angeliki A. Kakavouti–Doudou, Diamantis D. Almaliotis, Christos E. Sioulis and Vasileios E. Karampatakis have nothing to disclose.

Figures

Fig. 1
Fig. 1
Patient with eyelid entropion treated with ES. a Preoperatively, b 24 h postoperatively, c 12 months postoperatively
Fig. 2
Fig. 2
Patient with lower eyelid entropion treated with LTS. a preoperatively, b 12 months postoperatively
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Levine MR, Enlow MK, Terman S. Spastic entropion after cataract surgery. Ann Ophthalmol. 1992;24:195–198. - PubMed
    1. Pereira MG, Rodrigues MA, Rodrigues SA. Eyelid entropion. Semin Ophthalmol. 2010;25:52–58. doi: 10.3109/08820538.2010.488573. - DOI - PubMed
    1. Damasceno RW, Osaki MH, Dantas PE, Belfort R., Jr Involutional entropion and ectropion of the lower eyelid: prevalence and associated risk factors in the elderly population. Ophthal Plast Reconstr Surg. 2011;27:317–320. doi: 10.1097/IOP.0b013e3182115229. - DOI - PubMed
    1. Musch DC, Sugar A, Meyer RF. Demographic and predisposing factors in corneal ulceration. Arch Ophthalmol. 1983;101:1545–1548. doi: 10.1001/archopht.1983.01040020547007. - DOI - PubMed
    1. Marcet MM, Phelps PO, Lai JS. Involutional entropion: risk factors and surgical remedies. Curr Opin Ophthalmol. 2015;26:416–421. doi: 10.1097/ICU.0000000000000186. - DOI - PubMed

LinkOut - more resources