Lower-Eyelid Tarsal Ectropion Repair With the Putterman Ptosis Clamp for Lower-Eyelid Conjunctival Mueller’s Muscle Resection and Lateral Tendon Tuck

Abstract

To describe a technique for treatment of lower-eyelid tarsal ectropion using the Putterman ptosis clamp for excision of conjunctiva and Mueller's muscle as an adjunct to the lateral canthal tendon tuck. Retrospective case series. Patients with moderate-to-severe lower-eyelid ectropion underwent lateral canthal tendon tucking followed by eversion of the lower eyelid over a desmarres retractor, separation of the lower-eyelid conjunctiva and Mueller's muscle from the underlying capsulopalpebral fascia, placement of the Putterman ptosis clamp, and resection of the incarcerated tissue followed by closure of the conjunctiva and the lateral canthus. Six patients and 8 eyes were studied. Of the 8 eyes, 6 (75%) had complete resolution of tarsal ectropion and 2 (25%) had mild residual ectropion at last follow up. All 8 eyes (100%) had symptomatic improvement and 0 patients required re-operation. There were no noted severe adverse events. Lower-eyelid conjunctival Mueller's muscle resection using the Putterman ptosis clamp as an adjunct to lateral canthal tendon reinforcement is a safe and effective procedure in the treatment of lower-eyelid tarsal ectropion.