Treatment of refractory exposure keratitis with modified medial tarsorrhaphy using tarsoconjunctival flap

Sun Young Jang, Jinsook Yoon

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Abstract

Background This study reports the surgical technique of modified medial tarsorrhaphy using tarsoconjunctival advancement flap for treatment of exposure keratitis secondary to incomplete lid closure combined with ocular dysmotility or decreased corneal sensation. Methods Three patients suffered from intractable exposure keratitis due to incomplete lid closure with ocular motility limitation or decreased corneal sensation, even after the lateral tightening procedure. Because they did not want a cosmetically unacceptable appearance by permanent tarsorrhaphy, modified medial tarsorrhaphy using tarsoconjunctival advancement flap was performed. Clinical manifestation and surgical outcome were investigated through retrospective chart review. Results The minimum follow-up period was 10 months. All patients showed successful surgical results. Ocular symptoms were satisfactorily treated, corneal re-epithelialization was achieved and maintained during the follow-up period, lagophthalmos improved, and all patients were satisfied with their appearance. Conclusions We describe modified medial tarsorrhaphy with tarsoconjunctival advancement flap which was effective in treatment of severe exposure keratitis with incomplete lid closure in patients who elected not to have cosmetically problematic, permanent corrective surgery.

Original languageEnglish
Pages (from-to)1369-1372
Number of pages4
JournalGraefe's Archive for Clinical and Experimental Ophthalmology
Volume251
Issue number5
DOIs
Publication statusPublished - 2013 Jan 1

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Keratitis
Re-Epithelialization
Therapeutics

All Science Journal Classification (ASJC) codes

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

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title = "Treatment of refractory exposure keratitis with modified medial tarsorrhaphy using tarsoconjunctival flap",
abstract = "Background This study reports the surgical technique of modified medial tarsorrhaphy using tarsoconjunctival advancement flap for treatment of exposure keratitis secondary to incomplete lid closure combined with ocular dysmotility or decreased corneal sensation. Methods Three patients suffered from intractable exposure keratitis due to incomplete lid closure with ocular motility limitation or decreased corneal sensation, even after the lateral tightening procedure. Because they did not want a cosmetically unacceptable appearance by permanent tarsorrhaphy, modified medial tarsorrhaphy using tarsoconjunctival advancement flap was performed. Clinical manifestation and surgical outcome were investigated through retrospective chart review. Results The minimum follow-up period was 10 months. All patients showed successful surgical results. Ocular symptoms were satisfactorily treated, corneal re-epithelialization was achieved and maintained during the follow-up period, lagophthalmos improved, and all patients were satisfied with their appearance. Conclusions We describe modified medial tarsorrhaphy with tarsoconjunctival advancement flap which was effective in treatment of severe exposure keratitis with incomplete lid closure in patients who elected not to have cosmetically problematic, permanent corrective surgery.",
author = "Jang, {Sun Young} and Jinsook Yoon",
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AU - Yoon, Jinsook

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N2 - Background This study reports the surgical technique of modified medial tarsorrhaphy using tarsoconjunctival advancement flap for treatment of exposure keratitis secondary to incomplete lid closure combined with ocular dysmotility or decreased corneal sensation. Methods Three patients suffered from intractable exposure keratitis due to incomplete lid closure with ocular motility limitation or decreased corneal sensation, even after the lateral tightening procedure. Because they did not want a cosmetically unacceptable appearance by permanent tarsorrhaphy, modified medial tarsorrhaphy using tarsoconjunctival advancement flap was performed. Clinical manifestation and surgical outcome were investigated through retrospective chart review. Results The minimum follow-up period was 10 months. All patients showed successful surgical results. Ocular symptoms were satisfactorily treated, corneal re-epithelialization was achieved and maintained during the follow-up period, lagophthalmos improved, and all patients were satisfied with their appearance. Conclusions We describe modified medial tarsorrhaphy with tarsoconjunctival advancement flap which was effective in treatment of severe exposure keratitis with incomplete lid closure in patients who elected not to have cosmetically problematic, permanent corrective surgery.

AB - Background This study reports the surgical technique of modified medial tarsorrhaphy using tarsoconjunctival advancement flap for treatment of exposure keratitis secondary to incomplete lid closure combined with ocular dysmotility or decreased corneal sensation. Methods Three patients suffered from intractable exposure keratitis due to incomplete lid closure with ocular motility limitation or decreased corneal sensation, even after the lateral tightening procedure. Because they did not want a cosmetically unacceptable appearance by permanent tarsorrhaphy, modified medial tarsorrhaphy using tarsoconjunctival advancement flap was performed. Clinical manifestation and surgical outcome were investigated through retrospective chart review. Results The minimum follow-up period was 10 months. All patients showed successful surgical results. Ocular symptoms were satisfactorily treated, corneal re-epithelialization was achieved and maintained during the follow-up period, lagophthalmos improved, and all patients were satisfied with their appearance. Conclusions We describe modified medial tarsorrhaphy with tarsoconjunctival advancement flap which was effective in treatment of severe exposure keratitis with incomplete lid closure in patients who elected not to have cosmetically problematic, permanent corrective surgery.

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