Combined Z-plasty and horizontal shortening procedure for ectropion

A combined Z-plasty and horizontal shortening procedure to treat ectropions with cicatricial and horizontal laxity components successfully relieved ectropions in six patients. If the cicatricial changes are localized to one third or less of the eyelid, a skin Z-plasty to vertically lengthen the eyelid can be combined with a full-thickness pentagonal resection to horizontally tighten the eyelid.