Ectropion Repair Techniques and the Role of Adjunctive Superotemporal Skin Transposition for Tarsal Ectropion
Bibliographic record
Abstract
Background: Ectropion is a common eyelid problem and is defined as eversion of the eyelid margin and typically involves the lower eyelid. The main acquired causes of ectropion include involutional, cicatricial, paralytic, and mechanical. A severe manifestation of ectropion is tarsal ectropion, where much of the tarsal conjunctiva is visible, often with keratinization of the conjunctiva. causes. Common techniques for ectropion repair include horizontal tightening of the lid with lateral tarsal strip or Bick procedure, lateral tarsorraphy, inverting sutures and the sub-orbicularis oculi fat lift. However, all surgical techniques are prone to ectropion recurrence. We review the techniques for ectropion repair and describe a novel adjunctive technique called the superotemporal skin transposition (STS), which is well suited for patients with recurrent or tarsal ectropion. Methods: The STS is combined with a lateral tarsal strip or Bick procedure. For the STS, all of the anterior lamellae of the lateral lower lid is retained. The posterior lamellae is sutured to the lateral orbital tubercle. A triangular bed of skin is excised superotemporally, and the lower lid anterior lamellae is transposed and secured with multiple sutures. The STS can be combined with inverting sutures, or skin graft for cicatricial cases. Results: We used the STS with Bick procedure and optional inverting sutures on 23 patients, 4 of whom required bilateral ectropion repair. At 1–6 month followup all patients achieved satisfactory outcomes with a well-positioned eyelid and improved symptoms. The STS had more lateral cutaneous scarring than with a Bick procedure alone, but patients did not find this objectionable. No reoperations were required. Conclusion: The STS is a straightforward and useful adjunct for patients with severe, recurrent or tarsal ectropion. Further studies are needed to determine the long-term efficacy of this technique.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".