Cicatricial ectropion can be corrected by invasive surgical modalities such as full-thickness
skin graft, lateral tarsal strip procedure, etc., which are associated with donor
site morbidity and additional scars. Use of autologous fat graft (AFG) in treatment
of burn scars has previously shown encouraging clinical results as to skin color,
texture, and softness.
We aim to introduce the use of AFG for the correction of mild to moderate grades of
cicatricial ectropion of the lower eyelid in adult patients.
This was a prospective, interventional, non-comparative, pilot study including 5 patients
with a cicatricial ectropion of grade I-III. All these patients underwent a pre-injection
workup to assess anatomical outcomes (grade of ectropion, vertical palpebral aperture
(VPA), lagophthalmos, and eyelid retraction), functional outcomes (dry eye status)
and aesthetic outcome (change of scar color, thickness, pain, and consistency).
At 6-months follow-up assessment, all patients had improvement in grade of ectropion,
significant improvement in VPA and eyelid retraction, and almost complete resolution
of lagophthalmos in all the three patients who had pre-injection lagophthalmos. There
was a significant improvement in scar color, thickness and consistency on Visual Analogue
Score (VAS) with no donor site or systemic complications after the procedure but mild
pain on day 1 post-injection at the donor site
AFG transfer of cicatricial ectropion not only eludes the need of a invasive surgery
but provides satisfactory correction with stable outcome with an overall improvement
in texture of the scar and has low risk.