Lateral tarsoligamentous sling: A successful treatment for involutional entropion in Asians as a modified lateral tarsal strip

ObjectiveTo compare the effectiveness of the Quickert suture (Q-suture) with that of the lateral tarsoligamentous sling in treating lower eyelid involutional entropion in Asians.MethodWe reviewed the charts of all patients who underwent repair of an involutional lower eyelid entropion in Hangil Eye Hospital between September 2011 and March 2016. A single surgeon (S. C. Kim) performed the procedure in every case. Patients underwent either Q-suturing or lateral tarsoligamentous sling. We analyzed the results using Mann-Whitney and Chi-square tests, as well as Kaplan-Meier survival analysis. A p-value of <0.05 was considered to indicate significance.ResultsA total of 50 patients (61 eyes) were included in the study. Of the 50 patients, 24 (30 eyelids) received Q-suture and 26 patients (31 eyelids) underwent lateral tarsoligamentous sling. In all patients who underwent lateral tarsoligamentous sling, the entropion was successfully corrected and did not recur. Furthermore, none of the patients experienced any significant postoperative complications. In contrast, entropion recurred in 16 (36.67%) of the patients who underwent Q-suture (mean of 10.88 ± 9.02 months after surgery). The recurrence rate was not significantly correlated with age (p = 0.093); it was higher in men than in women, although this was not a significant difference (46.67% vs 26.6.7%; p = 0.175 by Chi-squared test). Kaplan-Meier survival analysis showed that the recurrence rate after Q-suture differed significantly from that after lateral tarsoligamentous sling (36.67% vs 0%, respectively; p = 0.007).ConclusionThis study suggests that lateral tarsoligamentous sling is an effective surgical method for correcting lower eyelid involutional entropion; the technique is not associated with recurrence or significant complications in Asians.