Transconjunctival correction of involutional entropion: A video demonstration

Area of Science:

• Ophthalmology
• Surgical Techniques

Background:

• Involutional entropion, common in the elderly, results from age-related tissue laxity and muscle tone loss.
• Key contributing factors include inferior retractor disinsertion, orbicularis muscle weakness, and eyelid/canthal tendon laxity.
• Clinical assessment involves evaluating eyelid laxity, muscle tone, and specific signs of retractor weakness.

Purpose of the Study:

• To demonstrate the surgical steps for transconjunctival correction of involutional entropion in a 70-year-old patient.
• To highlight the techniques for addressing both horizontal and vertical eyelid components.

Main Methods:

• The surgical approach involves horizontal tightening via a lateral tarsal strip procedure.
• Vertical tightening is achieved through advancement and reattachment of inferior retractors to the tarsus.
• The procedure is performed via a transconjunctival approach, avoiding external skin incisions.

Main Results:

• Successful correction of involutional entropion was achieved using combined horizontal and vertical tightening.
• The transconjunctival approach facilitated effective repair of eyelid laxity and retractor function.
• Suture removal at 2-3 weeks ensured strong attachment of the inferior retractors.

Conclusions:

• Transconjunctival correction effectively addresses involutional entropion by targeting both horizontal and vertical eyelid laxity.
• The procedure requires surgical expertise, and excessive skin excision is generally avoided in unilateral cases to prevent asymmetry.
• Proper suture management is crucial for robust inferior retractor reattachment and long-term success.