• Vol. 29 No. 4, 463–466
  • 15 July 2000

The Correction of Oriental Lower Lid Involutional Entropion Using the Combined Procedure



Introduction: Involutional entropion is a common lid malposition problem in the Chinese geriatric population. The major contributing factors of involutional entropion include disinsertion of the lower lid retractors and horizontal lid laxity. The combined procedure (lower lid retractor repair and lateral tarsal strip procedure) is a useful technique that tackles both the horizontal and vertical aetiologic components of this condition. The surgical technique of this procedure is described and the results and complications presented.

Materials and Methods: A retrospective non-randomised study on 41 lower eyelids of 38 Chinese patients. The combined procedure was performed by a single surgeon over a 2 years 11 months period. Nine patients had bilateral lid surgeries. The clinical charts and operative notes were reviewed by an observer.

Results: The mean age of the patients was 74.7 years (range 51 to 92 years). There were 14 males (36.8%) and 24 females (63.2%). The cases were followed up postoperatively for a mean duration of 13 months (range 3 to 48 months). Twelve lids had early postoperative overcorrection but the majority (8 lids) resolved spontaneously with good lid-globe apposition. Of the remaining 4 eyelids, 3 lids had persistent mild asymptomatic ectropion that did not require surgical treatment and only one required re-operation.

Conclusion: The combined procedure is an effective means of repair for oriental lower lid entropion with low complication rates.

Involutional entropion is a frequent cause of ocular irritation in the local elderly patients. The inturning of the lid margin and the eyelashes result in corneal epithelial damage that may predispose to vision-threatening infection and irreversible corneal scarring.

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