What Does Entropion Repair Address?
1) Laxity of the lower eyelid; 2) Attenuation or disinsertion of the lower eyelid retractors; 3) Over-riding of the orbicularis muscle. So in order to correct entropion, these three problems are addressed.
Success Rate In Patients
This is one Dr. Brock’s favorite surgeries to perform because the success rate and patient satisfaction is very high. The surgery is more predictable than some, because the anatomic problem is so well-defined, easy to recognize and there is a time-tested approach for surgical correction. When all three of the elements of entropion are not addressed, it is more likely that a patient will have recurrence. But when all three elements are addressed, the chance for success with long-lasting results is over 99%.
Causes of Entropion
In other instances, lower eyelid entropion may be caused by scarring of the posterior eyelid. This is called cicatricial entropion. It sometimes occurs following infection, inflammation, trauma or other surgeries. This condition and it’s treatment is very different from involutional entropion. For cicatricial entropion it is usually necessary to place some type of graft in the back of the eyelid to lengthen the eyelid.
Entropion: Upper Eyelids vs. Lower Eyelids
Entropion of the upper eyelids is much less common than that of the lower eyelids. There is almost always a cicatricial component to upper eyelid entropion, but often it is not known why the tissue may have scarred or contracted. At other times it is known to be secondary to previous trauma, surgery or illness. Entropion repair of the upper eyelid is also very different from involutional entropion of the lower eyelid. There are different options for entropion repair of the upper eyelid and all do not share the success rate that lower eyelid entropion repair offers. Options for upper eyelid entropion repair include marginal rotation, tarsal fracture, and mucous membrane grafting. Usually, mucous membrane grafting is the surgery of last resort. This is because the surgeon would rather perform the lowest risk and least invasive procedure initially and try to avoid the more invasive mucous membrane graft. But if the more conservative approaches fail, then mucous membrane grafting from the inside of the cheek or lip can be very effective.
Patients who have constant irritation from their eyelid turning against their eye are much relieved to have their entropion repaired.
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