3-Step combined technique for correction of involutional lower eyelid entropion: A case series

Involutional entropion of the lower eyelid is a common condition among the elderly. Numerous surgical techniques have been proposed to address its multifactorial nature, each focusing on different contributing factors. However, no single approach has proven to be superior. This study aims to evaluate the safety and effectiveness of a novel 3-step combined procedure in treating involutional entropion. Patients were treated using a combination of lateral lid-shortening with removal of a base-down triangle, myectomy of the orbicularis oculi muscle, and excision of a skin strip of the lower eyelid. We conducted a retrospective review of clinical data from patients who underwent this procedure between 2012 and 2023. Patient-reported satisfaction with aesthetic and functional outcomes were evaluated three months postoperatively with a custom 5-point Likert scale questionnaire. A total of 27 patients (30 eyelids) were included in the study, with a median follow-up period of 12 months (range 4-144 months). Minor surgical revision was required in one case for early wound dehiscence. One patient presented undercorrection, but reoperation was not needed. No other complications or recurrences were detected at the latest follow-up. All patients reported satisfaction with both functional and aesthetic outcomes three months after surgery. Based on our results, the 3-step combined procedure may represent a valuable addition to the range of surgical techniques for involutional lower eyelid entropion. This approach is associated with a high success rate and stable functional outcomes. Larger studies are warranted to further validate our results.