J Korean Ophthalmol Soc.  2015 Jun;56(6):803-810. 10.3341/jkos.2015.56.6.803.

Clinical Effectiveness of the Lateral Tarsal Strip Procedure

• Na KH
• Lee JS
• Lee H
• Baek SH

• KMID: 2339142
• DOI: http://doi.org/10.3341/jkos.2015.56.6.803

Abstract

PURPOSE
To evaluate the clinical indications and efficacy of the lateral tarsal strip procedure.
METHODS
The medical records of patients who underwent the lateral tarsal strip procedure between September 2008 and February 2014 were retrospectively reviewed. We examined age, gender, diagnosis, procedures simultaneously performed with the lateral tarsal strip, duration of observation, postoperative complications and cases requiring revision surgery. Patients without recurrence or undercorrection of eyelid/lateral canthal area lesions, surgical complication and not requiring revision surgery until final visit were considered as successful cases.
RESULTS
One hundred eighty-three eyes of 129 patients were included in this study. The mean patient age was 61.6 years and average follow-up duration was 9.2 months. Diagnoses of eyes were lower lid laxity (39.9%), involutional entropion (24.0%), lower lid retraction (14.8%), cicatricial ectropion (6.6%), lateral canthal deformity (5.5%), involutional ectropion (3.8%) and paralytic ectropion (2.7%). Surgical procedures simultaneously conducted with lateral tarsal strip in 167 eyes of 183 eyes were endoscopic dacryocystorhinostomy (30.5%), lower retractor tightening (19.2%), medial spindle procedure (13.8%), mid-lamellar lengthening (12.6%), lower blepharoplasty (10.8%), Quickert suture (4.2%) and Hotz's operation (3.0%). Successful results were obtained in 116 of 129 patients (89.9%).
CONCLUSIONS
The lateral tarsal strip procedure can successfully correct lower lid laxity and be used in various clinical indications with or without other surgical procedures.

Keyword

Lateral tarsal strip; Lid laxity

MeSH Terms

Blepharoplasty
Congenital Abnormalities
Dacryocystorhinostomy
Diagnosis
Ectropion
Entropion
Follow-Up Studies
Humans
Medical Records
Postoperative Complications
Recurrence
Retrospective Studies
Sutures

Figure

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  Figure 1. The lateral tarsal strip procedure. (A) After lateral canthotomy, the inferior crus of the lateral canthal tendon was released. (B) The tarsal strip was designed by separating the anterior lamella from the tarsus. (C) The palpebral conjunctiva overlying the tarsal strip was gently peeled with a No.15 blade. (D) The su-perolateral aspect of the tarsal strip was fully passed by vicryl suture on a P-2 semicircular needle. (E, F) The needle was rotated through the periosteum at the lateral orbital rim just above to the insertion of lateral canthal tendon and passed from posterolateral portion of the upper eyelid. (G) The tarsal strip was engaged with the suture and secured to the lateral orbital rim. (H) The skin was approximated with interrupted 7-0 silk sutures.

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  Figure 2. (A) A 67-year-old woman presents with involutional entropion and laxity of the right lower eyelid. (B) After tightening of inferior retractor and lateral tarsal strip procedure, she demonstrates normal eyelid contour.

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  Figure 3. (A) A 43-year-old woman with thyroid eye disease demonstrates lower eyelid retraction of both eyes. (B) Eyelid position has been corrected with mid-lamellar lengthening and lateral tarsal strip procedure.

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  Figure 4. (A) A 69-year-old woman presents with paralytic ectropion of the left eye. (B) Left lower eyelid has been in normal position after lateral tarsal strip.

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  Figure 5. Postoperative complications after lateral tarsal strip procedure. (A) Rounding deformity of the lateral canthus of the right eye. (B) Webbing of the lateral canthal area of the left eye.

Reference

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