Mechanical ectropion repair using tarsal rotation sutures

Chronic mechanical ectropion may persist despite elimination of its causal factors. Four such cases are presented in which traditional surgical management was not appropriate. Instead, tarsal rotation sutures were applied, eliminating the ectropion and deepening the inferior fornix in each case. This technique is presented in detail, along with a discussion of its mechanical principle which establishes the infraorbital rim as the center of rotation of the eyelid, anchoring the sutures and placing an inward torque on the tarsal plate.