blepharotomy versus tarsotomy in upper eyelid cicatricial entropion

purpose: to determine the success rate and complications of blepharotomy and tarsotomy in moderately severe upper eyelid cicatritial entropion. methods: this randomized clinical trial was conducted on patients with moderately severe cicatritial entropion. the patients were followed for six months and the results and complications were evaluated. success was defined as uncontacted eyelid margin and cilia to cornea. result: sixty upper eyelids of 37 patients (10 male and 27 female) underwent blepharotomy in 30 eyelids and tarsotomy in 30 other eyelids. mean age was 68.7±7.0 years in the blepharotomy group and 61.2±14 in the tarsotomy group. (p=0.3) trachoma was the undelying cause in all cases. success rate was 93.3% in the blepharotomy group and 96.7% in the tarsotomy group. (p=0.5) there was no significant difference between the two groups regarding complications of the procedures at the end of follow up except for eyelid notching which was significantly greater in the blepharotomy group. (16.7% vs 0, p=0.02) conclusion: blepharotomy and tarsotomy are successful operations in moderately severe cicatritial entropion. tarsotomy is easier and doesn't need a skin incision. we suggest tarsotomy as a better technique in patients with moderately severe trachomatic cicatritial entropion of the upper eyelids.