Surgical correction of lower-eyelid tarsal ectropion by reinsertion of the retractors

D. T. Tse, J. W. Kronish and D. Buus
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, FL 33101.

Lower-eyelid tarsal ectropion is an unusual form of eyelid malposition in which the entire lid is everted. The cause is most likely the disinsertion of the lower-eyelid retractors. In 12 eyelids of six patients, a transconjunctival approach was used to reunite the retractors with the inferior tarsal border. In eight eyelids, a horizontal tightening procedure was also needed. The looping passage of fornix sutures through the full thickness of the eyelid created a vector force that helped rotate the lid margin inward. The subsequent formation of an inflammatory cicatrix induced by the absorbable sutures also contributed to maintain the lid in an upright posture. During follow-up periods ranging from 8 to 36 months, there were no instances of overinversion, recurrent ectropion, or suture abscess.