Obtaining BTAINING inversion of the medial end of the lower lid with its everted punctum has always been a problem in atonic ectropion surgery. Cautery puncture, medial tarsorrhaphy,1 or medial conjunctivoplasty1 are frequently necessary as an adjunct to the more elaborate Kuhnt-Szymanowski procedure or its equivalent in order to get proper correction. The trouble is that the cautery puncture is ephemeral, while tarsorrhaphy and medial canthoplasty obstruct and shorten the palpebral fissure.
In 1938, Blaskovics2 published a procedure for ectropion at the medial canthus. I have used this—in modified form—with satisfaction for persistent atonic medial ectropion in all except advanced cases.
—A horizontal skin incision is made below the medial half of the lower lid 3 to 4 mm from the lid margin. The incision is carried upward and nasally following the curve of the lower lid. A narrow triangle of skin is resected in the nasocanthal
Fox SA. A Medial Ectropion Procedure. Arch Ophthalmol. 1968;80(4):494-495. doi:10.1001/archopht.1968.00980050496017