PURPOSE: In the present study, we introduced and evaluated the effectiveness of eyelid margin splitting combined with cilia rotation suture performed in simplified steps resulting in minimized complications in diffuse trichiasis. METHODS: A retrospective review of medical records was performed on 31 eyelids of 21 patients with diffuse trichiasis. The patients had trichiasis of more than 1/3 of eyelid margin and received eyelid margin splitting combined with cilia rotation suture at our hospital. The patients did not have eyelid or lid margin abnormalities and were followed up more than 6 months after surgical correction. A telephone survey of the surgical outcomes including cosmetic satisfaction and recurrence was conducted in patients who did not visit at postoperative 12 months. Success was defined as complete resolution of symptoms and acceptable cosmesis at final visit. RESULTS: The patients included 2 males (3 eyes) and 19 females (28 eyes) with an average age of 54.5 ± 18.3 years (range, 19.2–82.4 years). The mean follow-up period was 15.3 ± 5.6 months (range, 10–35 months). Cornea or conjunctiva irritation symptoms by misdirected eyelash were resolved in all eyelids; 3 eyelids with recurred trichiasis required additional electrolysis to remove irritating cilia resulting in an overall success rate of 90.3%. CONCLUSIONS: For patients with diffuse trichiasis, an eyelid margin splitting combined with cilia rotation suture performed in simplified surgical steps showed excellent results resolving irritating symptoms with very low recurrence rate and high cosmetic satisfaction.
Cilia* ; Conjunctiva ; Cornea ; Electrolysis ; Eyelids* ; Female ; Follow-Up Studies ; Humans ; Male ; Medical Records ; Recurrence ; Retrospective Studies ; Sutures* ; Telephone ; Trichiasis*

BACKGROUND: Trichiasis is the inward inversion of the eyelash, resulting in painful contact with the cornea, which is a common symptom of patients with leprosy seeking treatment in leprosy outpatient clinics. Recurrence rates are high when trichiasis is treated with conventional methods such as epilation and electrolysis. OBJECTIVE: To evaluate prospectively a more aggressive surgical technique, lid splitting with lash resection, for trichiasis in long standing leprosy as a pilot study. METHODS: During the past 10 months, we treated 12 leprosy patients (18 eyelids) for trichiasis by splitting the lid margin at the gray line with resection of the eyelash bearing portion to modify the anterior lamellar repositioning. RESULTS: In all patients, pain disappeared immediately and there were no complications. The low number of patients and relatively short follow-up period are study limitations. CONCLUSION: The lid splitting with lash resection for trichiasis in patients with long standing leprosy is a satisfied treatment method functionally and cosmetically.
Ambulatory Care Facilities ; Cornea ; Electrolysis ; Follow-Up Studies ; Hair Removal ; Humans ; Leprosy* ; Pilot Projects ; Prospective Studies ; Recurrence ; Trichiasis*

PURPOSE: To evaluate the long-term follow-up results of the eyelid margin tumor resection using a radio-frequency electrosurgical unit. METHODS: We retrospectively reviewed the medical records of 53 patients (55 eyes) diagnosed with eyelid margin tumor and who underwent eyelid tumor resection using a radio-frequency electrosurgical unit more than 5 years prior. Age, gender, undergoing a biopsy, recurrence,- and complications were examined through phone questions and the out-patient department. RESULTS: The study included 23 eyes of 22 males and, 32 eyes of 31 females, (age range 8.6-76.8 years). Surgical success rate was 95% (52 of 55 eyes) and mean follow-up period was 8.9 years. Thirty-four of 55 patients underwent a biopsy, and the most common cases were intradermal nevus and compound nevus (13 cases each), 2 cases of basal cell carcinoma (5.9%), 2 cases of actinic keratosis (5.9%), and, 2 cases of chronic inflammation (5.9%). Other cases included 1 case of squamous papilloma (2.9%) and 1 case of fibrosis (2.9%). There were 3 cases of recurrence. Eyelash-related complications after surgery occurred in 3 cases of trichiasis or distichiasis. CONCLUSIONS: Eyelid margin tumor resection using a radio-frequency electrosurgical unit is simple and showed high success rate. Additionally, it is considered as an effective method in the eyelid margin tumor resection due to low recurrence and complication rates in the long-term follow-up.
Biopsy ; Carcinoma, Basal Cell ; Eyelids* ; Female ; Fibrosis ; Follow-Up Studies ; Humans ; Inflammation ; Keratosis, Actinic ; Male ; Medical Records ; Nevus ; Nevus, Intradermal ; Outpatients ; Papilloma ; Recurrence ; Retrospective Studies ; Trichiasis

PURPOSE: To investigate the inhibitory effect of 0.02% mitomycin C on eyelash regrowth when injected to the eyelash hair follicle immediately after radiofrequency ablation. METHODS: We prospectively included 21 trichiasis patients from June 2011 to October 2012. Twenty eyes of 14 patients were treated with 0.02% mitomycin C to the hair follicle immediately after radiofrequency ablation in group 1, while radiofrequency ablation only was conducted in ten eyes of seven patients in group 2. Recurrences and complications were evaluated until six months after treatment. RESULTS: One hundred sixteen eyelashes of 20 eyes in group 1 underwent treatment, and 19 (16.4%) eyelashes recurred. Eighty-four eyelashes of ten eyes in group 2 underwent treatment, and 51 (60.7%) eyelashes recurred. No patients developed any complications related to mitomycin C. CONCLUSIONS: Application of 0.02% mitomycin C in conjunction with radiofrequency ablation may help to improve the success rate of radiofrequency ablation treatment in trichiasis patients.
Antibiotics, Antineoplastic/administration & dosage ; Catheter Ablation/*methods ; Dose-Response Relationship, Drug ; Eyelashes ; Female ; Follow-Up Studies ; Hair Follicle ; Humans ; Injections ; Male ; Middle Aged ; Mitomycin/*administration & dosage ; Prospective Studies ; Treatment Outcome ; Trichiasis/diagnosis/*therapy

PURPOSE: To investigate the inhibitory effect of 0.02% mitomycin C on eyelash regrowth when injected to the eyelash hair follicle immediately after radiofrequency ablation. METHODS: We prospectively included 21 trichiasis patients from June 2011 to October 2012. Twenty eyes of 14 patients were treated with 0.02% mitomycin C to the hair follicle immediately after radiofrequency ablation in group 1, while radiofrequency ablation only was conducted in ten eyes of seven patients in group 2. Recurrences and complications were evaluated until six months after treatment. RESULTS: One hundred sixteen eyelashes of 20 eyes in group 1 underwent treatment, and 19 (16.4%) eyelashes recurred. Eighty-four eyelashes of ten eyes in group 2 underwent treatment, and 51 (60.7%) eyelashes recurred. No patients developed any complications related to mitomycin C. CONCLUSIONS: Application of 0.02% mitomycin C in conjunction with radiofrequency ablation may help to improve the success rate of radiofrequency ablation treatment in trichiasis patients.
Antibiotics, Antineoplastic/administration & dosage ; Catheter Ablation/*methods ; Dose-Response Relationship, Drug ; Eyelashes ; Female ; Follow-Up Studies ; Hair Follicle ; Humans ; Injections ; Male ; Middle Aged ; Mitomycin/*administration & dosage ; Prospective Studies ; Treatment Outcome ; Trichiasis/diagnosis/*therapy

BACKGROUND: Defects caused by excision of benign lid margin tumors are conventionally repaired by reconstructive surgery. However, second intention healing is another option for managing wounds on the lid margin. OBJECTIVE: To evaluate the effectiveness of second intention healing after a shave excision of benign tumors on the lid margin. METHODS: Lid defects following a shave excision of the lid margin tumor were allowed to heal by second intention in 25 patients (26 lesions). The epithelialzation period was calculated, and cosmetic and functional results and complications were evaluated by photographs and ophthalmological examination. RESULTS: The locations of the defects were as follows: upper lid (n=13), lower lid (n=11), and both upper and lower lids (n=1). The mean tumor size was 3.8x3.6 mm, and the mean epithelialization period by second intention was 6.1+/-1.2 weeks. Pathological examinations revealed intradermal nevus (12 cases), compound nevus (five cases), squamous papilloma (five cases), and epidermal cyst (three cases). No patients had a corneal erosion, trichiasis, or hypertrophic scar, except loss of cilia in two cases. The functional and cosmetic results were satisfactory in all patients. CONCLUSION: Healing by second intention is a safe and effective alternative to surgical reconstruction after a shave excision of benign lid margin tumors.
Cicatrix, Hypertrophic ; Cilia ; Cosmetics ; Epidermal Cyst ; Humans ; Intention ; Nevus ; Nevus, Intradermal ; Papilloma ; Trichiasis

PURPOSE: The aim of the present study was to determine the effects of mitomycin C (MMC) on eyelash regrowth in rats. METHODS: Ten rats were subjected to bilateral eyelid epilation. One drop of 0.04% MMC solution and one drop of normal saline was then administered to the right and left eyelid, respectively. Three months post-epliation, the number of regrown eyelashes was counted, and a section of tissue from each eyelid was examined under light- and electron microscopies. RESULTS: The number of regrown long eyelashes was 1.0 +/- 0.81 on the right, and 12.5 +/- 1.08 on the left. The rate of regrowth was 7.35 +/- 5.55% on the right and 98.45 +/- 3.27% on the left. Histological examination revealed no significant differences between the right and left eyelids, except for the absence of any hair shafts in the follicles on the right. However, electron microscopy revealed mitochondrial damage in the follicles of the right eyelid. These changes were not observed in tissue from the left eyelid. CONCLUSIONS: The application of 0.04% MMC inhibited the regrowth of normal eyelashes in rats following simple epilation. These results suggest that MMC may be a novel therapy for replacing invasive surgery in trichiasis with no malpositioning.
Animals ; Electrons ; Eyelashes ; Eyelids ; Hair ; Hair Removal ; Microscopy, Electron ; Mitomycin ; Rats ; Trichiasis

BACKGROUND: Eyelash ptosis(ELP) is a common finding in patients with long-standing leprosy. However, it has rarely been reported in the literature previously, because it has been diagnosed as trichiasis or entropion. OBJECTIVE: To determine the prevalence of ELP in Hansen's disease. METHODS: We took both frontal and lateral photographs of eyes in 20 patients and evaluated the degree of ptosis using a 4-point rating scale, in which 0 indicates no ptosis; 1, minimal; 2, moderate; and 3, severe. The evaluation was also performed in 20 normal persons as control group. RESULTS: All patients demonstrated ELP. In general, severity of ptosis in patient group is greater than that in control group. While the mean eyelash ptosis rating was 2.0+/-0.6 in the latter, it was 0.6+/-0.4 in the former, which is statistically significant (p<0.01). CONCLUSIONS: ELP is common in the patients with Hansen's disease and moderate to severe forms occurred more commonly in disease group compared with control group. ELP must be considered as a characteristic ocular finding in long-standing leprosy.
Eye ; Humans ; Leprosy ; Prevalence ; Trichiasis

PURPOSE: To evaluate the clinical efficacy of a reverse eyelid splitting technique that we performed in cases of trichiasis or distichiasis combined with entropion. METHODS: The study comprised 43 eyes of 31 patients with trichiasis or distichiasis combined with entropion treated from November 2004 to December 2005. After skin incision, the muscular layer and tarsus were reversely dissected to find abnormal follicles. The abnormal hair follicle was cauterized under the muscular layer, and 2~3 rotating sutures were done with Ethilon 6-0 to fix the tarsus and skin. Success was defined as having the meibomian gland located in front of the junction of skin and mucosa, without an abnormal hair protruding into the eye for at least three months. RESULTS: Fifteen patients were male and sixteen patients were female. The mean age was 62.1+/-15.2 years. The patients were followed up for an average of 12.4+/-2.0 months after surgery. Surgery was successful in 74.4% (32 of the 43 eyelids) of the cases, and the recurrence rate was 25.6% (11 of the 43 eyelids). No severe complications occurred, such as infection, hemorrhage, wound dehiscence, or granuloma. However, foreign body sensation (1 eye) and eyelid notch (l eye) did occur. CONCLUSIONS: This reverse eyelid splitting technique produced satisfactory results in both cosmetic and functional aspects. Moreover, it resulted in a low recurrence rate and low complication rate in patients with trichiasis or distichiasis combined with entropion.
Ankle ; Entropion* ; Eyelids ; Female ; Foreign Bodies ; Granuloma ; Hair ; Hair Follicle ; Hemorrhage ; Humans ; Male ; Meibomian Glands ; Mucous Membrane ; Nylons ; Recurrence ; Sensation ; Skin ; Sutures ; Trichiasis* ; Wounds and Injuries

PURPOSE: To report our experience in the diagnosis and treatment of a localized corneal amyloidosis secondary to trichiasis. METHODS: Case 1. A 55-year-old woman visited our clinic due to discomfort of her right eye. Thirty years previously, she received a lower lid blepharoplasty due to lower lid entropion. Biomicroscopy revealed some trichiasis and a 3 mm, grayish-white nodule at the center of the cornea. Case 2. A 30-year-old woman visited our clinic due to chronic irritation of both eyes. Ten and 3 years previously, she received a lower lid blepharoplasty. Biomicroscopy revealed some trichiasis of the right lower lid and a grayish-white, patch-like lesion at the inferior cornea of both eyes. Lamellar keratectomy and amniotic membrane transplantation with careful electrolysis were performed. RESULTS: Hematoxylin and eosin stain revealed a pink, amorphous, hyaline material under the epithelium, and Congo-red stain showed birefringence of the whitish lesion. Electron microscopy revealed multidirectional, fibrillar arrangement. Secondary, localized amyloidosis of the cornea was diagnosed without any systemic involvement. No clues to the origin of the amyloid were found by immunohistochemical staining. By the sixth month after operation, the patients showed favorable vision and no evidence of recurrence. CONCLUSIONS: In the identification of a corneal mass, a secondary, localized amyloidosis should be considered, which can be managed successfully.
Adult ; Amnion ; Amyloid ; Amyloidosis* ; Birefringence ; Blepharoplasty ; Cornea ; Diagnosis ; Electrolysis ; Entropion ; Eosine Yellowish-(YS) ; Epithelium ; Female ; Hematoxylin ; Humans ; Hyalin ; Microscopy, Electron ; Middle Aged ; Recurrence ; Trichiasis*