Surgery without skin resection for eyelid entropion.

The previously reported surgical methods for eyelid entropion are basically manipulations of the skin or the conjunctival surface. When entropion is marked, manipulations also involve the tarsus. In the most widely used method, the eyelashes are directed outward by horizontal wedge resection of an appropriate amount of the excessive skin in the ciliary vestibule. This method is simple and effective but sometimes causes recurrences, conspicuous scars due to tension of the resection site, or lagophthalmos due to excessive resection. We speculated that partial swelling of the orbicularis muscle at the front of the tarsus is one of the main causes of pediatric eyelid entropion and found that correction of entropion is possible by partial resection of this muscle without skin resection. Eight patients with congenital entropion were treated by this method, and good results were obtained.