Posterior Lamellar Reconstruction With Nasal Septal Cartilage Grafts in Recurrent Cicatricial Lower Eyelid Entropion

This retrospective case series evaluates the clinical and functional outcomes of lower eyelid entropion correction using autologous nasal septal cartilage grafts.

Twelve patients (8 men, 4 women; mean age 76 y, range: 64-85) affected by unilateral cicatricial entropion, previously treated with unsuccessful tarsorrhaphy without grafts, underwent posterior lamellar reconstruction between September 2018 and December 2024 at the Presidio Ospedaliero San Filippo Neri, Rome. Primary involutional cases were excluded. The procedure involved transconjunctival placement of mucocartilaginous septal grafts to restore posterior lamellar support and lining. Preoperative and postoperative assessments included marginal reflex distance 2 (MRD2), palpebral fissure height (PFH), scleral show, trichiasis, and patient satisfaction using a visual analogue scale (VAS).

Mean MRD2 improved from 1.05±0.71 to 2.53±0.56 mm, and PFH from 5.90±1.11 to 7.31±0.75 mm, with a significant reduction in scleral show. All patients experienced resolution of trichiasis and symptomatic relief. No complications or recurrences were reported during a mean follow-up of 11.3 months (range: 8-16). Patient satisfaction averaged 8.4/10.

The technique proved safe and effective in restoring eyelid contour and function, making it a valuable option for managing recurrent cicatricial entropion in previously treated patients.