A small incision technique for repairing involutional lower eyelid entropion

The objective of this paper is to describe and review our experience with Goldberg's small incision technique for use with involutional entropion.

Retrospective consecutive interventional case series with validated late surgical outcomes were reported. All involutional entropion cases with horizontal laxity of less than 8 mm were repaired with a small incision technique. Retractors were separated from the tarsus by blunt dissection made from three 4 mm horizontal incisions. Three 6-0 double-armed polyglactin sutures were used to tighten retractors and the orbicularis oculi muscle. The sutures were removed 3 weeks postoperatively or earlier if overcorrection continued during the first week of the postoperative period. Data were obtained for a postoperative follow-up period of at least 24 months.

A total of thirty-seven lower eyelids from thirty-one patients with involutional entropion were included in the study. Primary operations were performed on 31 eyelids and reoperations on six eyelids. The mean follow-up time was 40 ± 11 months. Thirty-six (97.3%) of the eyelids had no recurrence. As overcorrection was seen postoperatively in ten eyelids (27%), a number of sutures had to be removed earlier than planned. The ectropion eventually resolved, and no recurrence was seen during follow-up in these patients.

In our practice, the small incision technique has been highly effective in involutional entropion repair, with minimal complications. Although this approach does not directly address lateral canthal tendon laxity, the procedure has the advantages of being easy to learn and also that it can be combined with other procedures for tendon laxity.