Faculty Collaboration Database

Surgical Microanatomy of Lower Eyelid Tarsal Ectropion Repair With a Putterman Ptosis Clamp. Ophthalmic Plast Reconstr Surg 2017;33(4):261-263

Date

07/19/2016

Pubmed ID

27429229

DOI

10.1097/IOP.0000000000000737

Scopus ID

2-s2.0-84978768115 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

PURPOSE: To examine the changes in microscopic anatomy of the lower eyelid tarsal ectropion repair with the Putterman ptosis clamp and better understand the anatomical changes associated with the eyelid malposition correction.

METHODS: Ten orbits from 5 fresh frozen cadaver heads, ranging in age from 53 to 77 years, were used for the dissection. For each head, a Putterman clamp tarsal ectropion repair was performed on one side, while the contralateral unoperated orbit served as a control. After performing the procedure, both orbits were exenterated and they, along with the resected specimens, were studied microscopically using Verhoeff-Masson trichrome and hematoxylin-eosin stains.

RESULTS: Conjunctiva, capsulopalpebral fascia, and smooth muscle were present on all tissue specimens incarcerated within the ptosis clamp. Tarsus was present in one specimen. There was a shortening of the posterior lamella of the eyelid with advancement of the capsulopalpebral fascia on all operated specimens when compared with controls.

CONCLUSION: The Putterman clamp ectropion repair works by shortening the posterior lamella of the eyelid and advancing the lower eyelid retractors superiorly. This advancement tightens the lower eyelid retractors and thus stabilizes the eyelid in a more vertical position. In addition to a lateral tendon tuck as described in the original article to tighten horizontal eyelid laxity, this procedure addresses both vertical and horizontal laxity of tarsal ectropion.

Author List

Jones ST, Aakalu VK, Lin AY, Perez C, Epstein G, Putterman AM, Setabutr P

Author

Vinay Kumar Aakalu MPH, MD Chair, Professor in the Ophthalmology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Blepharoplasty
Cadaver
Ectropion
Eyelids
Female
Humans
Male
Middle Aged
Orbit
Surgical Instruments