Background Information:

What are the other Names for the Procedure?

• Ectropion Repair Surgery

What is Ectropion Repair surgical procedure?

Ectropion Repair is a surgical procedure where excess cartilage from the eyelids is removed to treat, turn-out or eversion of (outwardly turned) eyelids; mostly of the lower eyelids.

What part of the Body does the Procedure involve?

An Ectropion Repair procedure involves the lower eyelids.

Why is the Ectropion Repair surgical procedure Performed?

There could be various reasons for performing an Ectropion Repair surgery. Some of them are as follows:

• Relieve redness
• Relieve discomfort and irritation
• Prevent eye infection
• Improve appearance

What are some Alternative Choices for the Procedure?

Medication, ointments, and artificial tear therapy are alternatives to the procedure.

What are the Recent Advances in the Procedure?

The use of laser techniques is a recent advancement in this procedure.

What is the Cost of performing the Ectropion Repair surgical procedure?

The cost of Ectropion Repair procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

• It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding procedure and what needs to be done
• If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
• Also, if the procedure involves multiple surgeries or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

http://www.mayoclinic.com/health/ectropion/DS01093/DSECTION=complications (Accessed on 8th August, 2012)

http://advancedeyenj.com/index.cfm/procedures/ectropionrepair (Accessed on 8th August, 2012)

Prior to Ectropion Repair surgical procedure:

How is the Ectropion Repair surgical procedure Performed?

• During an Ectropion Repair surgery, an incision is made on the eyelid
• A wedge-shaped portion of cartilage is cut and isolated from the outer edge of the lower eyelid
• Next, the cartilage is sewn and the process repeated at the inner portion (part of the eyelid close to the nose)
• After the remaining cartilage from both the sides of the eyelid is sewn together the skin is closed with sutures

Where is the Procedure Performed?

Ectropion Repair procedure is performed in a hospital, outpatient facility, or the ophthalmologist’s office. The patient is admitted, undergoes the procedure and is discharged as per the instruction of the physician.

Who Performs the Procedure?

The procedure is performed by an ophthalmologist.

How long will the Procedure take?

The procedure may take anywhere between 30 minutes to an hour.

What do you need to tell your Physician before the Procedure?

It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the surgical procedure and helps avoid unnecessary complications.

• Provide a complete list of medications you are currently, taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
• If you are allergic to any specific medication or food items
• If you are taking blood thinners, such as aspirin, warfarin, herbal supplements, or any other such medications
• If you or your family members, have a history of bleeding disorders, or if there is a tendency to bleed more than normal
• If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
• If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
• If you have a history of frequent bone fractures (this may affect bone-healing, if bones are involved as part of your procedure)
• A list of all previous surgical procedures you have undergone, like for example: Removal of appendix, gallbladder, or any other part, of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc. 

What Preparations are needed, prior to the Procedure?

• No particular preparations are needed prior to the procedure
• However, the physician may evaluate the patient’s medical history to gain a comprehensive knowledge of the medications that are being taken currently
• Some of the medication may increase the patient’s chances of bleeding and hence the physician may recommend them to stop such medications for a period of time before performing the procedure
• Sometimes, blood test might be performed to determine if the patient has a bleeding tendency or any other medical conditions that prevents them from undergoing the procedure
• Apart from these the patient must avoid application of any cosmetic or topical medicines on the area, before the procedure is to commence
• It is advisable to quit smoking and the use of any nicotine based products, for a while, before the surgery
• For persons suffering from diabetes, it is important that the blood sugar stays within the normal range; if not their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines
• A physician will request your consent for Ectropion Repair procedure using an Informed Consent Form.

What is the Consent Process before the Procedure?

A physician will request your consent for the Ectropion Repair procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What Tests are needed, before the Ectropion Repair surgical procedure?

Before an Ectropion Repair procedure, the patient has to undergo certain tests such as:

• Routine blood and urine analysis
• Eye examination
• The physician may suggest further tests depending on the health of the patient and their medical history.

What are some Questions for your Physician?

Some of the basic questions that you might ask your physician are as follows:

• What is an Ectropion Repair procedure?
• Why is this procedure necessary? 
• What does the procedure involve?
• How will this procedure help?
• Will it affect my sight? Will I be able to see immediately after the procedure?
• Are there chances of a recurrence?
• How soon should I get it done? Is it an emergency?
• Who are the medical personnel involved in this procedure?
• Where is the procedure performed?
• What are the risks while performing the procedure?
• What are the complications that might take place, during recovery?
• How long will it take to recover? When can I resume normal work?
• How many such procedures have you (the physician) performed?
• Are there any lifestyle restrictions or modifications required, after the procedure is performed?
• Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
• Is there any medication that needs to be taken for life, after the procedure?
• What are the costs involved?

During the Ectropion Repair surgical procedure:

What kind of Anesthesia is given, during the Procedure?

During the procedure the patient is administered local anesthesia, with or without intravenous sedation.

How much Blood will you lose, during the Procedure?

Since an Ectropion Repair procedure involves making small incisions that are not very deep; the amount of blood lost is minimal. The blood loss may vary from person to person though.

What are the possible Risks and Complications during the Ectropion Repair surgical procedure?

The possible risks or complications that may arise during the surgery are:

• Excessive bleeding
• Infection
• Accidental injury to neighboring tissue or cornea

What Post-Operative Care is needed at the Healthcare Facility after the Ectropion Repair surgical procedure?

At the healthcare facility, generally there is no requirement for any post-procedure care, unless any complications arise. 

After the Ectropion Repair surgical procedure:

What are the possible Risks and Complications after the Ectropion Repair surgical procedure?

The possible risks and complications post-surgery are:

• Infection in the surgical wound
• Hematoma
• Wound dehiscence (rupture of wound around the sutures)
• Improper placing of the eyelid

What is the Prognosis after the Surgery?

The recovery from an Ectropion Repair procedure is usually excellent.

When do you need to call your Physician?

Do contact your physician if you notice any of the following symptoms:

• Pain around the surgical wound
• Swelling and redness
• Bleeding or drainage
• Change in vision
• Fever
• Dizziness
• Muscle ache
• Nausea or vomiting
• Signs of infection
• If any new symptom or discomfort is observed

What Post-Operative Care is needed at Home after the Ectropion Repair surgical procedure?

At home, the following post-operative care is recommended, after Ectropion Repair procedure:

• Complete the course of medication
• Keep the incision site clean and dry
• Keep the eye area dry, for the first 5 days after surgery
• Shower baths may be taken
• Use warm compress to reduce swelling and pain, or follow directions of the physician
• Avoid taking non-prescribed medications

How long does it normally take to fully recover, from the Procedure?

It takes about 2 weeks to fully recover from an Ectropion Repair procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The tissue is taken for further examination and later disposed, as per the standard medical procedure.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

• The tissue removed is processed in the laboratory under a pathologist's supervision
• The slide(s) are prepared once the tissue is processed, and this is examined by a pathologist and a pathology report issued
• Depending on the complexity of the case, issue of the report may take anywhere between 72 hours to a week's time

Who will you receive a Bill from, after the Ectropion Repair surgical procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility charges and the physician charges. Alternatively, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

• The hospital, outpatient facility or the ophthalmologist’s office
• An ophthalmologist
• A pathologist (if the tissue was sent for analysis)

The patient is advised to inquire and confirm the type of billing, before an Ectropion Repair surgical procedure is performed.

Thanks and Gratitude:

We sincerely acknowledge and thank Dr. Douglas J. Jones for reviewing the article. His valuable input and feedback has helped enrich the contents of this article.

Douglas J. Jones, MD FACS
Board Certified General Surgeon and Faculty Member
University of Illinois, College of Medicine at Urbana-Champaign
506 S. Mathews Ave., Urbana, IL 61801, USA