Delayed Removal of Temporary Non-incisional Silk Suture in Senile Entropion; a Simple Method for Long-time Relief

Abstract

Purpose: To assess the long standing effects of transverse lid-everting silk suture in senile entropion. Methods: Eight patients (9 eyelids) who had only senile entropion participated in this prospective study. The lower lid had retractor laxity and upward migration of the pereseptal orbicularis muscle. The two Quickert-Rathbun silk suture is easily placed under local anesthesia. This is achieved with topical administration of tetracaine drops and subcutaneous infiltration of 2% lidocaine. The patient instilled topical bethamethasone and chloramphenicol every six hour for one week. All patients were followed up regularly at 1 week, 8 weeks, 16 weeks and then, every year for eye lid position (suture was removed after 12 weeks). Results: Except for one patient, the others had good lid position and no symptoms of corneal discomfort during the three months postoperative period. The other patient developed stitch abscess and responded to medical treatment and early removal of the suture. Conclusion: Although transverse lid everting suture has been used as a temporary measure in treatment of senile entropion, long standing three months silk lid sutures have been shown to have more permanent effect. The late removal of suture showed long lasting effects and cost-effectiveness as a simple outpatient procedure, especially in debilitated patients.