Cicatricial ectropion is an ocular disorder caused by the contracture of scar tissue. Clinically, it manifests as the outward turning of the palpebral conjunctiva, leading to the separation of the eyelid from close contact with the eyeball and incomplete closure of the palpebral fissure. Due to prolonged exposure after ectropion, the palpebral conjunctiva develops chronic conjunctivitis, and the direction of the eyelashes also undergoes significant changes. In cases of upper eyelid ectropion, the exposed cornea is prone to corneal trauma and keratitis, resulting in reduced vision or even blindness, with severe consequences. This condition is the most common type of all ectropion cases. It is often the result of eyelid burns or infections. After thorough preoperative anti-infection preparation to alleviate or resolve conjunctival inflammation, surgical treatment is performed. The ectropic eyelid is repositioned, and the wound is repaired according to its specific condition.

bubble_chart Clinical Manifestations

1. Scar traction pulls on the eyelid skin, causing exposure of the palpebral conjunctiva; 2. Incomplete closure of the upper and lower eyelids, exposure of the cornea, and tearing; 3. The conjunctiva becomes dry, congested, rough, and thickened due to prolonged exposure, and in severe cases, can lead to exposure keratitis and ulcers.

bubble_chart Diagnosis

1. History of burns, trauma, or infection; 2. Scar tissue pulling on the eyelid skin, causing exposure of the conjunctival membrane; 3. Incomplete closure of the upper and lower eyelids, exposure of the cornea, and tearing; 4. Conjunctival membrane becomes dry, congested, rough, and thickened due to prolonged exposure, potentially leading to severe exposure keratitis and ulcers.

1. Preoperative treatment for conjunctivitis and keratitis. 2. Scar release or excision, followed by full-thickness skin grafting for secondary wounds, with tarsorrhaphy performed if necessary. 3. Local flap transfer or V-Y plasty.

Expert Tip: Cicatricial ectropion is the most common type of eyelid ectropion, occurring more frequently than paralytic, senile, or spastic ectropion. It is often caused by the contraction of scar tissue after the healing of wounds involving local skin or deeper tissue injuries. Burns typically result in superficial injuries, and although the ectropion may appear severe, it is usually limited to the skin. Infections, however, may lead to deeper injuries, sometimes reaching the tarsal plate. Additionally, ectropion can occur due to depressed scars formed after the ulceration and expulsion of necrotic bone from maxillary osteomyelitis, commonly affecting the lower eyelid's outer and lower regions. Differentiating the causes and selecting appropriate surgical techniques can yield favorable outcomes.

bubble_chart Cure Criteria

1. Cured: Ectropion has been corrected, the eyelid can fully close, and the appearance is basically normal. 2. Improved: Ectropion is mostly corrected, but there remains grade I incomplete closure. 3. Not Cured: Ectropion is not corrected, and the eyelid has incomplete closure.