• Involutional medial ectropion responds poorly to traditional ectropion procedures. Eversion of the lacrimal punctum must be functionally corrected to reestablish normal corneal wetting physiology as well as tear-lake drainage. We describe our retropunctal approach with emphasis on a new, enhanced closure that utilizes the lower eyelid retractors. This stabilizes the medial eyelid margin in order to obtain and maintain good functional and cosmetic results. This procedure allows a predictable anatomic approach that is easily performed and can be combined with other procedures, such as a lateral tarsal strip, medial canthal tendon plication, or skin graft or flap, when required.
Nowinski TS, Anderson RL. The Medial Spindle Procedure for Involutional Medial Ectropion. Arch Ophthalmol. 1985;103(11):1750-1753. doi:10.1001/archopht.1985.01050110146045