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November 1985

The Medial Spindle Procedure for Involutional Medial Ectropion

Author Affiliations

From the Oculoplastic Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia (Dr Nowinski), and the Department of Ophthalmology, University of Utah School of Medicine, Salt Lake City (Dr Anderson).

Arch Ophthalmol. 1985;103(11):1750-1753. doi:10.1001/archopht.1985.01050110146045

• 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.