Surgical Correction of Lower Lid Ectropion

Surgery should only be performed by a surgeon with appropriate experience or a trainee who has had appropriate training in oculoplastics surgery

• Lower lid involutional ectropion with no horizontal lid laxity - perform a lateral tarsal strip procedure.
• Lower lid ectropion affecting mainly the medial lid with punctal eversion
  • if mild perform retro-punctal cautery
  • perform a tarsal conjunctivalplasty/ medial spindle procedure or a medial lid inversion (Tse’s procedure)
• Lower lid medial ectropian with lower eyelid laxity
  • Medical spindle procedure with a lateral tarsal strip

For other types of ectropion, i.e. those with medial canthal tendon laxity, recurrent ectropion or those with cicatricial changes - these should be referred to an oculoplastic surgeon.

Surgical Correction of Lower Lid Entropian

Surgery should only be performed by a surgeon with appropriate experience or a trainee who has had appropriate training in oculoplastics surgery

• Involutional entropian without lower lid laxity
  • Ideally, lower lid retractor placation/modified Jones procedure, if you have been shown how to do one by an oculoplastic surgeon.
  • everting sutures if patient cannot tolerate lengthy surgery.
  • botulinum toxin or Bandage Contact Lens or Taping lid out if patient declines surgery or cannot tolerate any surgery.
    
    
• Lower lid entropion with horizontal lid laxity
  • Primary procedure should be a lateral tarsal strip with everting sutures
  • If recurrence, a lateral tarsal strip with a Jones-type procedure
  • A Quickertt's procedure may be performed if you have been taught how to do one by an oculoplastics surgeon.

Recurrent entropion and cicatricial entropion - these should be referred to an oculoplastics team.

The procedure you do will obviously be dependent on your level of experience. If you are confident that you have good results with any other procedure then obviously those procedures can be performed.