American journal of ophthalmology · 2004
The use of a polyglactin suture in the lateral tarsal strip procedure.
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Hsuan James, Selva Dinesh
Аннотация
PURPOSE: To evaluate the rate of recurrence of horizontal laxity or lid malposition and suture-related complications associated with the use of an absorbable suture in the lateral tarsal strip procedure.
DESIGN: Prospective, interventional, consecutive case series.
METHODS: A prospective study.
SETTING: Institutional.
PATIENT POPULATION: One hundred patients with horizontal lid laxity associated with ectropion or entropion. Patients with paralytic ectropion or ocular prostheses were excluded.
INTERVENTION: One hundred and five lateral tarsal strip procedures were performed using a 6-0 polyglactin suture. These were combined with full-thickness skin grafts (34), internal (55) or external (23) retractor plications, and inverting sutures (4) as required to correct the lid malposition.
MAIN OUTCOME MEASURES: Recurrence of horizontal laxity or lid malposition and suture related complications were the main outcome measures. Suture related wound infection was diagnosed clinically by the presence of pus associated with wound breakdown.
RESULTS: One patient failed to reach 3-month follow-up and was excluded. There was one recurrence of horizontal laxity after a mean follow-up period of 9.1 months. Four patients developed lateral canthal wound infections, compared with none at the other operative sites. The 95% confidence intervals for infections in the tarsal strip procedure were 1.1% to 9.6%, which were significantly greater than zero (P < .0001), the infection rate for the other procedures.
CONCLUSION: A 6-0 absorbable suture may be used for the lateral tarsal strip and does not lead to a recurrence of horizontal laxity. It does not appear to reduce the wound infection rate associated with this procedure.
DESIGN: Prospective, interventional, consecutive case series.
METHODS: A prospective study.
SETTING: Institutional.
PATIENT POPULATION: One hundred patients with horizontal lid laxity associated with ectropion or entropion. Patients with paralytic ectropion or ocular prostheses were excluded.
INTERVENTION: One hundred and five lateral tarsal strip procedures were performed using a 6-0 polyglactin suture. These were combined with full-thickness skin grafts (34), internal (55) or external (23) retractor plications, and inverting sutures (4) as required to correct the lid malposition.
MAIN OUTCOME MEASURES: Recurrence of horizontal laxity or lid malposition and suture related complications were the main outcome measures. Suture related wound infection was diagnosed clinically by the presence of pus associated with wound breakdown.
RESULTS: One patient failed to reach 3-month follow-up and was excluded. There was one recurrence of horizontal laxity after a mean follow-up period of 9.1 months. Four patients developed lateral canthal wound infections, compared with none at the other operative sites. The 95% confidence intervals for infections in the tarsal strip procedure were 1.1% to 9.6%, which were significantly greater than zero (P < .0001), the infection rate for the other procedures.
CONCLUSION: A 6-0 absorbable suture may be used for the lateral tarsal strip and does not lead to a recurrence of horizontal laxity. It does not appear to reduce the wound infection rate associated with this procedure.