Postoperative Dry Eye Following Anterior Lamellar Recession Without Tarsal Fracture Versus Marginal Rotation With Tarsal Fracture in the Treatment of Cicatricial Entropion: A Comparative Study

Objective This study aimed to compare the postoperative dry eye parameters following anterior lamellar recession without tarsal fracture versus tarsal fracture with marginal rotation in patients treated for cicatricial entropion. Methods This retrospective cohort study included adult patients diagnosed with primary or recurrent cicatricial entropion who underwent either anterior lamellar recession without tarsal fracture or tarsal fracture with marginal rotation. A comprehensive ocular assessment was performed pre- and postoperatively, including evaluation of tear film meniscus level, tear break-up time (TBUT), corneal fluorescein staining, Schirmer test, and Ocular Surface Disease Index (OSDI) questionnaire. In addition, the recurrence of entropion and associated symptoms was assessed. Results A total of 50 eyes were included in the study. Group A consisted of 25 patients who underwent anterior lamellar recession without tarsal fracture, with a mean age of 59.2±5.1 years. Group B consisted of 25 patients who underwent marginal rotation with tarsal fracture, with a mean age of 59.3±5.0 years. Both groups showed different degrees of deterioration of tear film stability after surgery. Group A showed significantly better results regarding the tear film meniscus level (p<0.001), TBUT (p=0.009), and OSDI (p=0.002) compared to group B. Meanwhile, the two groups were comparable regarding the recurrence rate (p=0.384). Conclusion Both procedures have a comparable success rate. However, anterior lamellar recession without tarsal fracture is associated with better results in terms of tear film stability and quality in the postoperative period.