From theory to practice: An identical surgical technique for tarsal ectropion and involutional entropion

Two newly described clinical-anatomical entities form the basis of a common pathogenetic theory for tarsal ectropion and involutional entropion: an isolated dehiscence of the posterior bundle of the lower lid retractors for tarsal ectropion and this plus dehiscence of the anterior bundle for involutional entropion. Based on this unifying algorithm, we propose identical surgical management of these two forms of lid malposition; the surgical goal in both cases is to correct the altered position of the retractors as a priority. Moreover, the local anesthetic, surgical instruments and sutures are the same, as is the conjunctival approach. The surgical reinsertion of the retractors specific to each of the two types of malposition, combined with a lateral canthoplasty if necessary, and the post-operative course are all the same. Operating on a tarsal ectropion or an involutional entropion in the same way has the advantage of simplifying surgical management, making it easier to learn the technique and optimising operating room time and logistics.