Current techniques of entropion and ectropion correction

The entities of entropion and ectropion have some important common factors in their genesis. Preoperative examination requires similar careful assessment and planning. The need for surgery must first be established, and the changes in the anatomy must be evaluated. Prior local trauma or surgery, conjunctival or skin changes, septal shortening, weakness of muscles, retractor thinning or dehiscence, orbicularis muscle shift, and, most importantly, the status of the lateral canthal tendon must all be considered. In performing any eyelid surgery, entropion or ectropion should not be produced, and preventive techniques must be incorporated into such undertakings. Anesthetic injections should be subcutaneous and only as deep as needed. The amount injected should not be excessive, because distortion or stretching can occur. Dealing with orbital fat should never involve any pulling, which can shear off a deep orbital vessel with serious consequences. Immediate and adequate measures for intraorbital bleeding should be familiar to the surgeon and instituted without delay. Restoration of lid anatomy with precise surgical methods yields improved lid function, comfort, and cosmesis.