What is the best strategy for Asians with involutional entropion?

Even though many different procedures have been proposed to involutional entropion, there is no established criterion standard in terms of the choice of the operative method. Considering the anatomical difference of the lower eyelid structure between Asians and whites, we evaluated the effectiveness of our surgical approach to involutional entropion exclusively for Japanese patients.

Twenty-one patients complained of discomfort around the eye, and they also suffered from foreign body sensation, ocular pain, epiphora, and photophobia. All the patients with the involutional entropion were surgically treated with combined procedures (the lower eyelid retractors advancement, the modified Hotz method, and the modified Wheeler method).

Twenty-three lower eyelids of 21 patients with involutional entropion underwent surgery. There were 10 men and 11 women with a mean age of 78 years (range, 69-94 years). All patients we operated on were completely satisfied with any residual ocular symptoms. There was no case of recurrence following the primary procedure during 16 months of the mean follow-up period.

Based on the anatomical difference in various ethnic groups, we propose the best strategy for Asian patients with the involutional entropion.