We appreciate Dr Hedin's comments regarding transconjunctival entropion repair, in which he describes his experience with the transconjunctival approach.1 Although his description of a surgical approach to transconjunctival entropion repair may have predated our own, the results he achieved were less than ideal. Of the 13 patients who underwent repair, five continued to show evidence of entropion and one required a second operation. In addition, a fold of conjunctiva developed in four patients at the site of the incision. There are several factors underlying the unsuccessful surgical results that Dr Hedin described. The approach he outlined is one in which the lower eyelid retractors are simply reattached to the inferior tarsal border. This ignores the other lower eyelid abnormalities that are responsible for involutional entropion, namely, the horizontal laxity of the eyelid and lateral canthal tendon and the overriding of the preseptal orbicularis oculi muscle. In addition,
Karesh J, Dresner S. Transconjunctival Entropion Surgery-Reply. Arch Ophthalmol. 1995;113(6):702. doi:10.1001/archopht.1995.01100060024014
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