Involutional entropion repair by posterior lamella tightening and myectomy.

Involutional entropion is a common eyelid malposition of diverse etiology that may recur after surgical repair. Laxity of the tarsoligamentous complex combined with posteriorly directed rotational force exerted by the orbicularis, in our view, seems to be the most important in the production of entropion. A surgical technique has been developed that is carried out through a standard transcutaneous lower eyelid blepharoplasty incision. It includes tarsoligamentous tightening at the lateral canthus, bolstering of the lateral canthal tendon, and partial orbicularis myectomy. Forty-two procedures in 35 consecutive patients (29% for recurrent entropion) have been performed and evaluated (mean follow-up, 33 months). There have been no recurrences, and the esthetic outcome has been very good.