Transconjunctival Approach for Involutional Entropion: Suggestions and Drawbacks.

Area of Science:

• Ophthalmology
• Surgical Techniques
• Eyelid Surgery

Background:

• Current involutional lower eyelid entropion (ILLE) repairs predominantly utilize transcutaneous approaches targeting the lower eyelid retractor (LER).
• The transconjunctival approach is explored for ILLE repair due to its advantages of a concealed postoperative scar and direct access to the LER.

Purpose of the Study:

• To present surgical suggestions and highlight drawbacks of the transconjunctival approach for ILLE repair based on clinical experience.
• To evaluate the efficacy and patient outcomes of the transconjunctival method in ILLE surgery.

Main Methods:

• A transconjunctival approach was employed by two surgeons for entropion repair in 14 eyelids across 13 patients.
• The procedure involved conjunctival incision, separation of conjunctiva and LER, dissection of LER sheets, fixation to the tarsus, and conjunctival suturing.

Main Results:

• The mean operative time for the procedure was 32.6 minutes.
• A single recurrence was noted in one of the 14 eyelids, occurring at an average of 6.6 months postoperatively.

Conclusions:

• Sufficient detachment of the LER's anterior-posterior aspects and fixation to the tarsus are recommended for optimal ILLE repair.
• Potential drawbacks include insufficient correction for cases with positive pinch or medial traction tests, though no postoperative maintenance is required.