Reader Comments

Lutazene Review

by Ellen Thomas (2019-04-03)

Upper lid Lutazene retraction can cause dry-eye symptoms and corneal exposure, and may even induce a corneal ulcer due to inadequate lid closure. It also contributes significantly to cosmetic disfigurement. Due to the tendency for spontaneous improvement, surgery for isolated upper lid retraction is usually performed only after at least one year of observation. Eyelid retraction surgery is performed after decompressive and strabismus surgeries have been completed and the lid position has been stable for six months or more. Upper lid retraction is corrected with a levator recession operation. The levator muscle (muscle that lifts the eyelid) is lengthened, thus allowing the upper lid to cover more of the eye. One can think of this operation as the opposite of a ptosis (drooping eyelid) repair. Lower eyelid retraction is a common problem in TAO' patients. Patients with lower eyelid retraction complain of tearing, dryness, and foreign-body sensation. They frequently have evidence of exposure keratopathy. The most commonly used method of elevating the lid involves placing a tissue spacer within the back surface of the eyelid, thus effectively elongating the lower lid. Ectropion refers to an out-turned lower eyelid and can occur for three different reasons. The most common is age-related involutional ectropion, where there is excessive laxity in the bottom lid. The next most common type is paralytic ectropion, where there is partial or complete paralysis of the facial muscles, such as after a stroke or from Bell's palsy. The third type is cicatrial (scarring) ectropion, caused by trauma related scarring or skin diseases with tightening of the skin. Symptoms include tearing, mattering of the lashes, irritation, and erythema (redness) of the eye's bottom lid.Involutional (age-related) and paralytic ectropion are repaired by tightening. A small incision is made in the outer corner of the bottom lid, which is tightened and reattached just inside the lateral orbital rim -- like a "nip and tuck." This is performed as a same day surgery with light sedation and local anesthesia. Cicatricial ectropion is a bit more complicated to repair. Sometimes, a skin graft is required. Entropion refers to an in-turned bottom lid, where the lashes are rubbing against the eyeball. This can be quite irritating to a patient, and, if left untreated, can cause permanent damage to the cornea and loss of vision. Involutional (age related) is the most common type of entropion. This is caused by vertical laxity in the lower lid retractors (muscles that pull the lower lid down and back) combined with horizontal laxity in within the lower lid.Symptoms include chronic redness, irritation, tearing, foreign body sensation, and loss of vision.Entropion repair is performed as a same-day surgery with light sedation and local anesthesia. Treatment is aimed at tightening the lower lid retractor muscles through a small incision just beneath the lower lashes. An additional lower lid tightening procedure is performed through a small incision at the outer corner of the eyelids. The incisions are closed with fine absorbable sutures.