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All Journal Ophthalmologica Indonesiana
Niluh Putu Ayu Dewi Wardhani
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Health Professions Medicine & Pharmacology Public Health

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Management of Recurrent Entropion in Traumatic Proptosis: Poster Presentation - Case Report - Ophthalmologist ANGGA KARTIWA; George Raden Mas Said; Niluh Putu Ayu Dewi Wardhani; Shanti Fitrianti Boesoirie; Mohamad Rinaldi Dahlan
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/0a7grr81

Abstract

Introduction : Shortening of posterior lamella due to fibrotic tissue is the pathomechanism of cicactricial entropion. It may be complicated by proptosis in a post traumatic patient which may require repeated repair procedure. Case Illustration : A 29-year-old woman came with complaints of protruding left eye since being hit by an iron tip 2 months prior. She also complained off double vision. Left eye presenting visual acuity was 0.08 with hipotropic position, proptosis, lid retraction, and entropion of the inferior lid. CT scan examination showed unremarkable results. The patient then underwent forced duction test, exploration, and muscle restriction release on the left eye, followed by inferior rectus recess and superior rectus resect procedures 3 months later. A month later the patient underwent entropion repair in the left eye using the tarsal fracture method. However, a week later the patient complained of a recurrent entropion, thus a grey line splitting procedure combined with retractor repositioning and tightening of the tarsus was performed. At the 7 days follow-up time, the eyelid margin was succesfully everted with an acceptable result. Discussion : Skin graft procedure is one of the option for cicatricial entropion. However, its risk of recurrences and more difficult secondary repair can be harrowing. Thus, a grey line splitting procedure is an alternative that can be considered. Conclusion : Combined procedure of grey line splitting, retractor repositioning, and posterior lamellar tightening showed a good cosmetic result in an uncommon case of entropion.
RECURRENT CONGENITAL PTOSIS MANAGEMENT BY SUPRAMAXIMAL LEVATOR RESECTION TECHNIQUE: Poster Presentation - Case Report - Resident Desi Kristina Utami; Shanti F. Boesoirie; Raden Angga Kartiwa; Niluh Putu Ayu Dewi Wardhani; Mohamad Rinaldi Dahlan
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/tfv2zv98

Abstract

Introduction : Congenital ptosis is an abnormal low position of the eyelid since birth. Levator resection technique is one of the surgery technique for ptosis corection. Recurrence could be occured even after ptosis correction Case Illustration : A 22 year old male presented with a chief complaint of droopy left eyelid since birth. Visual aquity were 0,08 pinhole 0,2 and 0,25 pinhole 0,63 respectively. Opthalmology examination revealed interpalpebral fissure (IPF) 4 mm, margin reflex distance (MRD)1 0 mm, MRD2 4 mm and levator function test (LFT) 6 mm on the left eye (Figure 1). Levator resection technique was conducted on his left eye with a good result, MRD1 2 mm, MRD2 5 mm, IPF 7 mm. But the lid dropped again after3 months (Figure 2). Opthalmology examination of the left eye showed IPF 5 mm, MRD1 0 mm, MRD2 5 mm, LFT 2 mm and lagophtalmos 1 mm. Second surgery was done with supramaximal levator resection technique. Good result was achieved after second surgery, MRD1 3 mm, MRD2 5 mm, IPF 8 mm (Figure 3). Discussion : Recurrent ptosis could occured after ptosis surgery and had challenges due to scar from previous surgery. Frontal suspension technique was recommended for congenital ptosis levator function less than 4 mm. Supramaximal levator resection was done for this patient, with resection of 30 mm levator muscle, which had result as good as of frontal suspension technique. Conclusion : Levator resection technique could be repeated to repair recurrent congenital ptosis. Supramaximal levator resection technique is one of the option.
Management of Recurrent Entropion in Traumatic Proptosis: Poster Presentation - Case Report - Ophthalmologist ANGGA KARTIWA; George Raden Mas Said; Niluh Putu Ayu Dewi Wardhani; Shanti Fitrianti Boesoirie; Mohamad Rinaldi Dahlan
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/y9r7ge58

Abstract

Introduction : Shortening of posterior lamella due to fibrotic tissue is the pathomechanism of cicactricial entropion. It may be complicated by proptosis in a post traumatic patient which may require repeated repair procedure. Case Illustration : A 29-year-old woman came with complaints of protruding left eye since being hit by an iron tip 2 months prior. She also complained off double vision. Left eye presenting visual acuity was 0.08 with hipotropic position, proptosis, lid retraction, and entropion of the inferior lid. CT scan examination showed unremarkable results. The patient then underwent forced duction test, exploration, and muscle restriction release on the left eye, followed by inferior rectus recess and superior rectus resect procedures 3 months later. A month later the patient underwent entropion repair in the left eye using the tarsal fracture method. However, a week later the patient complained of a recurrent entropion, thus a grey line splitting procedure combined with retractor repositioning and tightening of the tarsus was performed. At the 7 days follow-up time, the eyelid margin was succesfully everted with an acceptable result. Discussion : Skin graft procedure is one of the option for cicatricial entropion. However, its risk of recurrences and more difficult secondary repair can be harrowing. Thus, a grey line splitting procedure is an alternative that can be considered. Conclusion : Combined procedure of grey line splitting, retractor repositioning, and posterior lamellar tightening showed a good cosmetic result in an uncommon case of entropion.
SIE BOEN LIAN (SBL) SURGICAL TECHNIQUE FOR CICATRICIAL ENTROPION AFTER STEVENS-JOHNSON SYNDROME: Poster Presentation - Case Report - Resident GEORGE RADEN MAS SAID; Niluh Putu Ayu Dewi Wardhani; Raden Rangga Kartiwa; Shanti Fitriani Boesoirie; Mohamed Rinaldi Dahlan
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/7745mf74

Abstract

Introduction : Stevens-Johnson Syndrome (SJS) can cause keratinization of the tarsal conjunctiva, conjunctival scarring and inverted eyelid margin, resulting to cicatricial entropion, causing skin and lashes to brush against the eye. This condition can occur in 27-59% of cases in ocular SJS. The surgical treatment for cicatricial entropion is to repair the position of eyelid margin. One of the procedures that can be used is Sie Boen Lian (SBL) technique. Case Illustration : A 70-year-old woman complained of inversion of the left upper eyelid, which caused foreign body sensation, redness, and lacrimation since 4 months ago. The patient had a history of SJS caused by the use of quinolone antibiotic. Anterior segment examination revealed entropion in the left upper eyelid with palpebral margin keratinizing. The patient was diagnosed with cicatricial entropion post- SJS. SBL surgical technique was chose to manage this condition. Post-operative ophthalmological examination showed a relieved symptoms and an improvement in the position of the eyelid margin. Discussion : The primary goal of therapy in cicatricial entropion is to reduce the occurrence of chronic ocular irritation by reverting the structure of the eyelids to a physiological position. The anterior lamellar shortening was performed with a modified tarsotomy, known as the SBL surgical technique. The post-operative evaluation was implemented to assess the reposition of the eyelid margin. Conclusion : The SBL surgical procedure is effective to manage cicatricial entropion post-Steven-Johnson Syndrome.
Co-Authors ANGGA KARTIWA Desi Kristina Utami George Raden Mas Said Mohamad Rinaldi Dahlan Mohamed Rinaldi Dahlan Raden Angga Kartiwa Raden Rangga Kartiwa Shanti F. Boesoirie Shanti Fitriani Boesoirie Shanti Fitrianti Boesoirie