Lower lid retractors tucking with gray-line splitting procedure in the management of lower eyelid involutional entropion with misdirected lashes

Abstract

Purpose The aim was to assess the outcome of a surgical technique of lower lid retractors tucking with gray-line splitting procedure in the management of patients with unilateral lower eyelid involutional entropion with misdirected lashes. Patients and methods This prospective case series included 60 patients with unilateral lower eyelid involutional entropion with misdirected lashes and no previous history of entropion correction surgery. Patients with cicatricial and traumatic lower lid entropion were excluded. Eyelid margin splitting was done first along the gray line, then lower lid retractors tucking was done through a transcutaneous incision using three horizontal 5-0 vicryl sutures and redundant skin was excised. All patients were followed up at 1 day, 1 week, and 3, 6, and 12 months postoperatively. Results Success rate after 1 year was 92.6% (n=50/54) and recurrence occurred in 7.4% (n=4/54). Overall, six patients were excluded owing to incomplete follow-up and excluded from statistics. Postoperative temporary ectropion occurred in 85% in the first 3 weeks. Patient opinion and satisfactions reached up to 92% at the end of the year. Conclusion Lower lid retractors tucking with gray-line splitting is a highly effective, simple surgical technique that is less traumatizing to conjunctiva and has good cosmetic results.