Role of reinsertion of the lower eyelid retractor on involutional entropion

Abstract

Aims: To verify and evaluate the effect of reinsertion of the lower eyelid retractor aponeurosis to correct involutional entropion.

Methods: The involutional entropion is one affection that occurs mainly in the lower eyelid of patients over 60 years old. The surgical techniques proposed to correct this condition are based on correction of horizontal laxity-the preseptal orbicularis muscle overrides the pretarsal muscle, and the reinsertion of the lower eyelid retractor aponeurosis. 30 patients clinically diagnosed with involutional entropion and randomly selected underwent reinsertion of the lower eyelid retractor aponeurosis to the tarsal plate, without horizontal shortening or resection of the skin or orbicularis muscle.

Results: Good anatomical and functional correction was achieved in 96.6% of the patients and no recurrence was observed on 29 month follow up examination. The surgical result was very satisfactory.

Conclusions: It was concluded that this procedure is effective and has low recurrence rate, showing the important role of the reinsertion of the lower eyelid retractor aponeurosis in this surgical correction.

Figure 1

Patient selected for surgical procedure.

Figure 2

Identification of aponeurosis was confirmed by holding it with forceps and asking the patient to look downwards.

Figure 3

Follow up visit, with good positioning of the eyelid margin.