Ectropion following excision of lower eyelid tumours and full thickness skin graft repair

A retrospective review was performed to define the incidence of post operative lower eyelid ectropion after excision and full thickness grafting of lower eyelid tumours. In a 7-year period (1995–2001) 106 consecutive patients were identified who had undergone such surgery with mean follow-up period of 7.4 months (median 5 months, range 1–41.5 months). The majority of lesions were basal cell carcinomas 89/106 (84%). A total of 15/106 (14.2%) patients developed ectropion. The length of follow-up for patients with ectropion was on average 11.7 months (median 10 months, range 2–34 months). Ten patients underwent corrective surgery with five of these showing cosmetic and symptomatic improvement. Of five patients treated conservatively, three showed spontaneous improvement. The incidence of lower eyelid ectropion after lower eyelid skin grafting is defined and this does not seem to have been reported before for a consecutive series of patients. We offer a classification for eyelid zones with regard to ectropion and anatomical and pathological factors that may be important for ectropion formation are discussed. Finally we suggest a new classification of ectropion based on cosmetic and functional consequences.