Involutional lower-eyelid entropion has three underlying correctable causes: eyelid laxity, overriding of the orbicularis oculi muscle, and attenuation of the lower-eyelid retractors. We describe a new technique for correcting this problem. A transconjunctival approach is used to advance or fortify the lower-eyelid retractors. The orbicularis oculi muscle can also be addressed through this approach. Combining this technique with lateral canthal resuspension anatomically corrects the entropion by addressing all three correctable causes. Transconjunctival blepharoplasty can also be performed in conjunction with this technique. Twenty-three eyelids of 18 patients successfully underwent this procedure. Six patients underwent simultaneous transconjunctival blepharoplasty. Follow-up ranged between 9 and 18 months. There were no postoperative recurrences, overcorrections, or lower-eyelid retraction. This approach yields a stable and definitive repair of involutional entropion with excellent postoperative cosmesis.
Dresner SC, Karesh JW. Transconjunctival Entropion Repair. Arch Ophthalmol. 1993;111(8):1144-1148. doi:10.1001/archopht.1993.01090080140030