The medial spindle procedure for involutional medial ectropion
T. S. Nowinski and R. L. Anderson
Involutional medial ectropion responds poorly to traditional ectropion
procedures. Eversion of the lacrimal punctum must be functionally corrected
to reestablish normal corneal wetting physiology as well as tear-lake
drainage. We describe our retropunctal approach with emphasis on a new,
enhanced closure that utilizes the lower eyelid retractors. This stabilizes
the medial eyelid margin in order to obtain and maintain good functional
and cosmetic results. This procedure allows a predictable anatomic approach
that is easily performed and can be combined with other procedures, such as
a lateral tarsal strip, medial canthal tendon plication, or skin graft or
flap, when required.
