Carbon dioxide laser repair of medial ectropion

Five patients with medial eyelid ectropion and punctal eversion due to senile changes, cicatrix, or vertical skin tightness were treated with a heretofore unreported method. Using a carbon dioxide laser, an ellipse of conjunctival-tarsal-inferior muscle tissue was excised from the inner surface of the ectropic lid inferior to the punctum. There was no bleeding, and each postoperative course was notable for minimal pain and edema. Lengthy follow-up revealed good anatomic results, with normal functioning of the inferior punctum. Patients taking warfarin sodium (Coumadin) have been treated without bleeding. Carbon dioxide laser ectropion repair may be tailored to each patient's specific condition, and is performed with ease in the office, thus offering diminished patient anxiety, discomfort, and expense.