Purpose: A study to evaluate the effectiveness of a modified procedure to correct involutional entropion. Methods: Seventeen cases of involutional entropion underwent surgery and had a postoperative follow-up of 18 months. The authors describe a technique of vertically shortening the anterior lamella (skin and orbicularis muscle), using a blepharoplasty incision and reflection of a skin muscle flap. Results: In 16 of 17 eyelids affected by involutional entropion, this operative procedure showed good functional outcome (good correction of the relation between lower eyelid edge and eyeball) and aesthetic outcome (no hypertrophic scar, dyschromia or unnatural folding of the skin). Conclusions: A correct approach to entropion surgery needs an accurate preoperative evaluation of the individual physiopathogenic factors. This procedure gives lasting functional and pleasing cosmetic results when preseptal orbicularis muscle override has been identified as the cause of senile entropion.

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