Oculofacial Surgery: Plastic Surgical Techniques Forthe Eye, Nose, Ear and Palate

Entropion is a common condition in small animal practice that allows the surgeon an excellent opportunity to perform satisfying and sometimes creative procedures. Adequate surgical planning consists of identification and, where possible, treatment of the cause of the entropion, selection of technique and instruments, good patient positioning, and evaluation of amount of tissue resected.

Getting the most from a Hotz-Celsus Procesure for Entropion

The majority of cases of simple, breed-related or conformational entropion can be addressed using a Hotz-Celsus procedure. Most practitioners are already familiar with this technique. The purpose of this description is to highlight some helpful hints to improve success rates.

1. Preoperative Considerations:
a. Eliminate spastic entropion prior to deciding on the extent of surgical resection
b. Always assess patients prior to administration of sedative medications.
c. Note preoperatively whether the extent of resection is likely to be symmetrical.
d. Consider a sterile dermatological marker pen for defining the extent of resection.

2. The Incisions:
a. The initial incision is parallel to the eyelid margin at the haired, non-haired border. (A common error is to place this incision too far from the eyelid margin.)
b. Make this incision longer than the full extent of the entropion.
c. Decide on the width of the resection at the most severely rolled in point and then determine whether to make the lateral and medial ends of the “smile” symmetrical.
d. Resection of the orbicularis muscle is unnecessary. Eyelid tissue is best resected with a small pair of tenotomy scissors in a “V”- or “boat keel”-type of pattern.

3. Suturing:
a. Place multiple, small, closely-spaced sutures perpendicular to the eyelid margin.
b. Use the “rule of bisection”.

4. Postoperative Management:
a. Triple antibiotic ophthalmic ointment
b. An E-collar is essential
c. Suture removal 7-10 days postoperatively. [...]