Surgical Correction of Senile Entropion

ABSTRACT

Senile entropion is caused by following pathophysiology 1) Dehiscence or disinsertion of lower lid retractors from lower tarsus, 2) Preseptal orbicularis overriding pretarsal orbicularis, 3) Horizontal lid laxity from involutional changes of medial canthal ligament, lateral canthal ligament and tarsal plate, 4) Relative enophthalmos from absorption of orbital fat. There have been numerous procedures to correct senile entropion, but lack of adequate correction of all of the underlying anatomic defects resulted in high recurrence rate. Authors performed a combined procedure including the reinsertion of disinserted or dehisced lower lid retractor to lower tarsus, the excision of overriding preseptal orbicularis, and the correction of the lower lid laxity using lateral tarsal strip procedure all at once Among 11 cases of 10 patients, 10 cases had cosmetically and functionally good lid position during the mean follow up periods of 13.4 months. There was one case of ectropion as a complication which was corrected by further lateral tarsal strip procedure.