Modified Orbicularis Oculi Muscle Shortening for Repairing Involutional Lower Eyelid Entropion

Lower eyelid entropion, a common condition in the elderly, is typically addressed surgically using the Wheeler method. This retrospective study aimed to assess the outcomes of 2 modified orbicularis oculi muscle shortening techniques in the correction of involutional lower eyelid entropion.

A total of 175 patients with lower eyelid entropion who were treated between 2021 and 2023 were included in this study. Sixty-nine patients (75 eyes) underwent the modified orbicularis oculi muscle overlap (OOMO) procedure, while 36 patients (40 eyes) underwent the orbicularis oculi muscle truncation (OOMT) method. Patients' discomfort, postoperative outcomes, satisfaction levels, and recurrence rates were evaluated at 1, 6 months, and 1-year after surgery.

Successful correction of lower eyelid entropion was achieved in all patients. No significant differences in sex, age, or ocular surface issues were observed between the 2 groups before surgery. The surgical time was significantly shorter in the OOMO group compared with the OOMT group (P<0.001). The OOMT group exhibited a higher overcorrection rate at the 1-year follow-up (P=0.048). The recurrence rate was 1.33% in the OOMO group and 5% in the OOMT group (P=0.24). Patient satisfaction, particularly regarding relief from ocular surface problems, was significantly higher in the OOMO group (P<0.05).

Both modified orbicularis oculi muscle shortening techniques demonstrated immediate resolution of entropion. The OOMO procedure exhibited a lower overcorrection rate and higher patient satisfaction compared with the OOMT method. These findings suggest that the modified orbicularis oculi muscle overlap technique may be a preferable option for correcting involutional lower eyelid entropion.