• Vol. 40 No. 2, 84–89
  • 15 February 2011

A 5-year Retrospective Review of Asian Ectropion: How Does It Compare to Ectropion Amongst Non-Asians?



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Introduction: This study reviews the differences in demographics and surgical outcomes between ectropion in Asian and non-Asian eyes.

Materials and Methods: Medical records of surgically corrected ectropion cases from January 2002 to December 2006 were reviewed. Pre and postoperative lid-globe apposition was graded: grade 0 with normal lid-globe apposition, grade 1 with punctal ectropion, grade 2 with partial lid eversion and scleral show, grade 3 with conjunctival hyperemia and thickening and grade 4 as for grade 3 with exposure keratitis.

Results: Sixty-nine eyes in 50 patients underwent surgical correction of lower lid ectropion, making up 3.3% of all lid procedures performed. Eighty-four percent of patients were above 50 years of age, 72% were males and 88% were Chinese. Involutional change was the commonest aetiology, accounting for the majority of bilateral cases. The mean duration to surgery was 10.0 ± 16.0 months. The most frequent preoperative severity grade was 2. Lateral tarsal strip (LTS) was the commonest procedure performed, comprising 91.3% of eyes. The mean duration of postoperative review was 19.4 ± 19.2 months (range, 1 to 74 months). Postoperative improvement of at least one grade was observed in 98% while normal lid-globe apposition was achieved in 76% of eyes.

Conclusions: Involutional change is the most common cause of ectropion amongst both Asians and non-Asians. Ectropion is less prevalent amongst Asians as a result of anatomical differences and possibly reduced sun exposure. The LTS procedure is the most commonly performed surgical procedure for the successful correction of ectropion in both Asians and non-Asians.

Ectropion is defined as the outward rotation of the eyelid margin, commonly affecting the lower lids and to a much lesser extent, the upper lids. The prevalence of lower lid ectropion has been shown to increase with age in the Blue Mountain Eye Study, with up to 16.7% amongst subjects above 80 years of age.

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