[Surgery of advanced atonic senile ectropion]

In cases of senile ectropion the orbicularis muscle and the skin of the lower eyelid lose their elasticity and tonus. After excision of the conjunctiva and the tarsus, enlarged by granulomatous inflammation, the free posterior border of the lower eyelid is nicely applied against the eyeball and the lower eyelid recovers its elasticity and practically normal tonus. Often excess fibro-elastic tissue forms a spontaneous vertical fold over a distance half of the distance over which the eyelid should have been shortened. Excision of the excess tucked lower eyelid tissue results in a highly satisfactory esthetic and functional cure.