Entropium in dogs and its correction

Abstract

Entropium or the twisting of eyelides presents one of the most common eyelid diseases in dogs, and therefore its surgical correction is one of the most frequent surgical procedures in veterinary eye surgery. Due to insufficient training and the application of inadequate techniques, deformities occur that affect even the eyeball. Eventually, ulceral keratitis usually appears which can result in the perforation of the cornea, and, consequently, in most cases, the loss of an eye. It is usually not very difficult to make a diagnosis, especially when the eyelied is twisted. In entropium therapy surgical treatment is an imperative. Other methods have a more or less historical significance. A surgical correction is necessary in almost every case of entropium. A great number of surgical techniques for correcting entropium have been described, but they are often unnecessarily complicated and do not provide significantly better results. The choice of the technique itself depends on the case, the size of the affected eyelid surface, and the intensity of entropium. The most commonly applied technique for the correction of entropum is the Hotz-Celsus procedure. This technique yields the best results, and at the same time is the easiest to perform, especially for a surgeon who is not very experienced. The Hotz-Celsus technique is performed in the following manner: part of the skin close to the edge of the eyelid is removed in the shape of an ellipse, the wound is then stitched and the eyelid is thus tightened, i.e. restored to its normal position. The Y and V technique is more complicated but more precise, and it is performed mostly on the central part of the eyelid. The medical cantal V plastic is primarily done in corrections of medial entropium. The recommended material is Nylon, and in this area silk from 6.0 to 4.0 also be used.

Entropium ili uvrtanje očnih kapaka predstavlja jedno od najčešćih oboljenja očnih kapaka kod pasa, a samim tim i njegova hirurška korekcija je jedna od najzastupljenijih hirurških procedura u veterinarskoj oftalmohirurgiji. Zbog nedovoljne edukovanosti i primene neadekvatne tehnike često nastaju takvi deformiteti koji ugrožavaju i samu očnu jabučicu. Na kraju, najčešće se javlja i ulcerativni keratitis kod koga se, kao posledica, može da javi perforacija rožnjače, a samim tim, u najvećem broju slučajeva, i gubitak oka. Postavljanje dijagnoze najčešće nije teško pogotovo kada je prisutno uvrtanje kapaka. U terapiji entropijuma hirurški tretman je imperativ. Ostale metode imaju manje-više istorijski značaj. Hirurška korekcija je neophodna u skoro svim slučajevima entropijuma. Postoji veliki broj hirurških tehnika koje su opisane za korekciju entropijuma, a one su često nepotrebno komplikovane i ne postižu se značajno bolji rezultati. Izbor same tehnike zavisi od datog slučaja, dela kapka koji je zahvaćen, kao i intenziteta entropijuma. Najčešće primenjivana tehnika u korekciji entropijuma je procedura po Hotz-Celsusu. Od svih tehnika njom se postižu najbolji rezultati, a ujedno je i najlakša za izvođenje, pogotovo za nedovoljno iskusnog hirurga. Hotz-Celsus tehnika se izvodi na taj način što se deo kože blizu ivice kapka odstrani u obliku elipse, rana se zašije i time kapak zategne, tj. vrati u normalan položaj. Y i V tehnika je komplikovanija, ali i preciznija tehnika koja se sprovodi prvenstveno na centralnom delu kapka. Medijalna kantalna V plastika se prvenstveno radi kao korekcija medijalnog entropijuma.