Eyelid: Transverse Everting Sutures (Quickert Sutures, Three-Suture Technique)

Abstract

Entropion of the lower eyelid can lead to ocular surface irritation due to the lashes and eyelid skin rubbing against the cornea. If not corrected, permanent scarring of the cornea and loss of vision can result. Involutional entropion is believed to occur secondary to dehiscence of the lower eyelid retractors, horizontal eyelid laxity, and overriding of the preseptal orbicularis over the pretarsal orbicularis (Techniques in ophthalmic plastic surgery. Philadelphia: Saunders Elsevier, 2010). In spastic entropion, ocular irritation or inflammation leads to spasm of the eyelids, resulting in entropion (Techniques in ophthalmic plastic surgery. Philadelphia: Saunders Elsevier, 2010). The Quickert suture technique, first described by Quickert and Rathbun (Arch Ophthalmol 85:304–305, 1971), temporarily corrects lower eyelid entropion by plicating the lower eyelid retractors. This technique does not address the horizontal laxity component that contribute to involutional entropion and is not a permanent solution for involutional or spastic entropion. It is, however, a powerful tool to temporarily relieve patient discomfort and prevent scarring of the cornea until definitive surgery can be performed.