Published online May 12, 2014. doi: 10.5318/wjo.v4.i2.7
Revised: February 12, 2014
Accepted: February 16, 2014
Published online: May 12, 2014
A variety of surgical techniques have traditionally been used to manage cicatricial ectropion. These techniques primarily aim at vertical lengthening of the anterior lamella and include a variety of skin flaps and grafts. Alternative techniques such as dermal filler injection to support the eyelid margin may also be used in the management of select patients with cicatricial ectropion. The application of different types of laser for scar revision throughout the body has rapidly evolved; similar mechanisms, principles and treatment rationale can be applied to the use of lasers in the management of cicatricial ectropion. Additionally, ablative lasers, such as Carbon Dioxide and Erbium:yttrium-aluminum-garnet lasers, may be used in the transdermal delivery of antifibrotic agents, such as interferon gamma, interferon alpha, vitamin D, triamcinolone and 5-fluorouracil, resulting in efficient target tissue penetration, limitation of systemic drug toxicity and decreased degradation. Although the combination of ablative fractional resurfacing and topical antifibrotic agents is a new treatment modality, there is a great potential for its efficient utility in the management of periocular scarring and cicatricial ectropion. The introduction of these innovative therapeutic modalities offers ophthalmologists a greater range of possible effective treatments to address periocular scar tissue and the resultant cicatricial ectropion.
Core tip: There is a broad range of conservative as well as more invasive treatment modalities for cicatricial ectropion. Ablative lasers can be used alone or in conjunction with nonablative lasers in the treatment of periocular scarring and cicatricial ectropion. Additionally, they may be used to assist the transdermal delivery of antifibrotic agents. This treatment modality, although still uncommonly used to treat periocular scarring, is a promising new technique that offers many advantages. Ophthalmologists may utilize this technique to manage cicatricial ectropion.