What are the other Names for the Procedure?
- Entropion Surgery
What is the Entropion Repair surgical procedure?
- Entropion is a medical condition characterized by the shortening of excess eyelid tissue, resulting in the eyelashes rubbing against eye
- Entropion Repair is a surgical procedure that involves the division of the excess tissue and cartilage surrounding the eyelid, thereby preventing the ‘turning in’ of the edge of the eyelid
What part of the Body does the Procedure involve?
An Entropion Repair surgical procedure involves the skin and cartilage surrounding the upper eyelid.
Why is the Entropion Repair surgical procedure Performed?
An Entropion Repair is performed for the following reasons:
- To improve visual appearance
- Relieve redness, irritation, and discomfort, caused by excess tissue and cartilage around the eyelid
What are some Alternative Choices for the Procedure?
Various techniques are available (described above) and the surgeon determines the technique according to his/her experience and expertise.
What are the Recent Advances in the Procedure?
Various new surgical techniques are some of the recent advances to the procedure. The surgeon determines the technique, according to his experience and expertise.
What is the Cost of performing the Entropion Repair surgical procedure?
The cost of Entropion 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 by the information regarding Entropion Repair procedure and on what needs to be done
- If the patient needs further reassurance or a second opinion, a physician will almost always assist and also recommend another physician, if required
- They can also choose to approach another physician independently. Besides, if the procedure has many alternatives, the patient may take a second opinion to understand and choose the best one
What are some Helpful Resources?
Complete Guide to Symptoms, Illness & Surgery; Written by H Winter Griffith, M.D.; Revised and updated by Stephen Moore, M.D. and Kenneth Yoder, M.D.; The Berkley Publishing Group, 5th Edition, New York, 2006
Prior to Entropion Repair surgical procedure:
How is the Entropion Repair surgical procedure Performed?
An Entropion Repair procedure can be performed under local anesthesia, with or without intravenous sedation.
Quickert Repair procedure:
- It is a repair technique performed without any incision
- The procedure is used on patients who are not suitable for surgery, or until a more definitive operation can be performed
- 2 or 3 sutures are placed to evert (turn outward) the eyelid
- There is an increased chance of recurrence with this procedure
Other techniques are described:
- The skin and underlying muscle is incised and then, the upper and lower flaps are created, following which, sutures are placed to approximate the upper and lower edges
- In another technique, the lower lid is tightened horizontally and vertically in such a way that the upper lid Entropion is corrected
Where is the Procedure Performed?
An Entropion Repair procedure is usually performed in an out-patient surgery center facility, an ophthalmologist’s office, or a hospital.
Who Performs the Procedure?
An ophthalmologist performs the Entropion Repair surgical procedure.
How long will the Procedure take?
The procedure takes about 45 minutes to an hour, to perform.
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?
- The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are being currently taken
- Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time, before the procedure is performed
- Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
- Do inform the physician if you are allergic to any local anesthetics, lidocaine, etc.
- Avoid application of any cosmetics, deodorant, or topical medicines on the area, prior to the procedure
- It is advisable to quit smoking and the use of any nicotine based products, for a while, before the surgery
- Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
- The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
- 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 the Entropion Repair procedure using an Informed Consent Form.
What is the Consent Process before the Procedure?
A physician will request your consent for the Entropion 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 Entropion Repair surgical procedure?
Before an Entropion Repair procedure, the patient has to undergo certain tests, such as:
- Routine blood and urine analysis
- Eye examination
What are some Questions for your Physician?
Some of the basic questions that you might ask your physician are as follows:
- What is an Entropion Repair procedure?
- Why is this procedure necessary? How will it help?
- 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?
- What are the alternatives to the procedure?
- How many such procedures have you (the physician) performed?
- Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
- What are the costs involved?
During the Entropion Repair surgical procedure:
What kind of Anesthesia is given, during the Procedure?
The procedure is usually performed under local anesthesia, with or without intravenous sedation.
How much Blood will you lose, during the Procedure?
Since it is a less invasive procedure, the amount of blood loss is minimal.
What are the possible Risks and Complications during the Entropion Repair surgical procedure?
There are general factors that increase the risk of getting complications during surgery and they include:
- Obesity: Generally greater the degree of obesity, greater is the surgical risk
- Smoking: Longer the smoking history (in pack years smoked), greater the surgical risk
- Advancing age
- Poorly controlled diabetes, as evidenced by a high hemoglobin A1c and a high fasting glucose
- Poorly functioning kidney, as evidenced by increased BUN (blood urea nitrogen) and blood creatinine
- Poorly functioning liver, as evidenced by increased blood liver function tests
- Hypertension (increased blood pressure), especially if it is poorly controlled
- Poor nutritional status (malnutrition with mineral and vitamin deficiencies)
- Poor lung function, as evidenced by abnormal lung function tests
- History of bleeding disorders
- Longstanding illness, such as autoimmune disorders, chronic infections
- Poor immune system due to a variety of causes
- The possible risks or complications that may arise during the surgery are:
- Anesthetic complications
- Accidental injury to the neighboring tissues
What Post-Operative Care is needed at the Healthcare Facility after the Entropion Repair surgical procedure?
At the healthcare facility, usually there is no requirement for any post-procedure care, unless any complications arise.
After the Entropion Repair surgical procedure:
What are the possible Risks and Complications after the Entropion Repair surgical procedure?
Post Entropion Repair surgical procedure, the following complications may arise:
- Infection in the surgical wound
- Vision loss
- Recurrence of Entropion
- The wound may open up
What is the Prognosis after the Surgery?
The prognosis is excellent, if the surgery is performed before damage to the cornea occurs.
When do you need to call your Physician?
Do contact your physician if you notice any of the following symptoms:
- Worsening pain and swelling around the surgical wound
- Bleeding or fluid drainage from around the surgical wound
- The occurrence of any symptom that causes uneasiness, such as nausea and vomiting
- Signs of infection
- Muscle aches
- Feeling sick
- Changes in vision
- Complications associated with prescription medications used for the treatment
What Post-Operative Care is needed at Home after the Entropion Repair surgical procedure?
At home, the following post-operative care is recommended, after an Entropion Repair procedure:
- Resume regular/daily activities, as early as possible (under advice by the physician). This aids in a faster recovery
- Keep the wound clean and dry
- Complete the course of prescribed medication, under advice of the physician
- Avoid taking nonprescription medications
- Avoid all activities that are physically strenuous for 2-3 weeks
How long does it normally take to fully recover, from the Procedure?
- Most individuals feel better, immediately after the surgery
- In some patients, the recovery may take about 3-4 weeks
What happens to tissue (if any), taken out during the Procedure?
The procedure does not involve the surgical removal of any tissue.
When should you expect results from the pathologist regarding tissue taken out, during the Procedure?
Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.
Who will you receive a Bill from, after the Entropion 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 other healthcare providers.
Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:
- The outpatient facility, physician’s office or hospital
- An anesthesiologist (if anesthesia was administered)
- An ophthalmologist
The patient is advised to inquire and confirm the type of billing, before the Entropion Repair 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