Ectropion Management Using Plasma Assisted Non-Invasive Surgery (Panis); 6-Month Follow-Up Case Series

Ectropion is a subgroup of eyelid malposition diseases that is highly prevalent in the aged population. This study will investigate whether the PANIS technique (plasma-assisted non-invasive surgery) may manage ectropion in an office-based method.

Ectropion was treated in six eyes of six patients using local anesthesia in an office-based manner behind a slit-lamp. 

Plasma spots were generated with the PLEXR PLUS device - Power = 1 W (GMV Srl, Rome, Italy). The spots were used to sublimate the palpebral conjunctiva after pulling outward the lower eyelid in two sessions with a one-month interval. Visual parameters, dry eye tests, OSDI questionnaire, and patient satisfaction were evaluated before and 6 months after the second PANIS session.

Six eyes of six patients, including 2 females and 4 males, with a mean age of 70.17 years. Uncorrected Visual Acuity (UCVA) improved in 4 cases by 1 line. Additionally, Best-Corrected Visual Acuity (BCVA) showed improvement in 2 patients after 6 months. Intraocular pressure (IOP) differences were not significant. The mean value of tear meniscus height (TMH) improvement was 0.085. Considering the improvement of ectropion grades, two cases showed a 3-level improvement, three cases showed a 1-level improvement, and one case showed a 2-level improvement. Furthermore, no need for further surgical treatment occurred.

The PANIS method can offer an office-based and safe procedure for both cosmetic and functional eyelid treatment. Without any sutures or invasive approaches, ectropion can be ameliorated with this cost-effective method.