Lower eyelid ectropion repair with lateral tarsal strip and medial spindle procedure

One of the most common causes of lower lid ectropion is horizontal lid laxity, the incidence of which increases with age. This condition induces poor ocular surface tear film coverage which leads to irritation, tearing, and keratopathy. Lateral tarsal strip fixation is the technique which is widely used to repair involutional ectropion due to horizontal lid laxity. Medial spindle procedure is the well-known technique for puntal ectropion correction. Both surgeries are minimally invasive, simple and effective.

Contributors
Suzanne K. Freitag, MD, Ophthalmic Plastic Surgery Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School
Thidarat Tanking, MD, Ophthalmic Plastic Surgery Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School

Lower Eyelid Entropion Repair with Lateral Tarsal Strip and Infraciliary Rotation

This combined procedure addresses multiple anatomic factors causing involutional entropion: the lateral tarsal strip is suspended to reduce horizontal laxity, and infraciliary rotation sutures are placed to stabilize the tarsus, evert the lower eyelid, and decrease orbicularis override. This approach is both efficient and effective, with a low risk of complications.

Frontalis Suspension Blepharoptosis Repair

Frontalis suspension blepharoptosis repair is the procedure of choice for the repair of blepharoptosis in the context of poor levator function (< 4mm). Numerous sling materials have been described for this procedure, however, preferred materials include banked, Tutoplast or autologous fascia lata, or silicone rods. This video demonstrates frontalis suspension utilizing silicone rods. Authors: Jay C. Wang, MD (Massachusetts Eye and Ear) Suzanne K. Freitag, MD (Massachusetts Eye and Ear)

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