Surgery for involutional entropion

Surgery for involutional entropion must correct horizontal eyelid laxity, vertical laxity, and overriding of the tarsus by the infra-tarsal tissues. The surgery should give lasting functional and pleasing cosmetic results. These goals are achieved with: 1) a blepharoplasty incision and reflection of a skin-muscle flap; 2) excision of a wedge of eyelid tissue at the lateral canthus; 3) barrier sutures or tuck of the retractors; 4) reattachment of the lid to the lateral orbital rim; and 5) excision of excess skin.