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Background. The eyelids are movable folds that protect the eyeball from external influences and carry out a supporting function. A misalignment of the eyelids can seriously effect on the ocular function.Purpose. To evaluate the effectiveness of surgical treatment of spastic lower lid entropion.Patients and methods. The results of treating patients with eyelid entropion for the period from 2014 to 2021 were analyzed — 66 people, 85 operations. All patients with eyelid entropion underwent a standard ophthalmological examination and additional studies, which revealed the presence of a spastic component. The pathogenetically substantiated methods of surgical treatment were performed.Results and discussion. In all 69 cases, where operations were performed according to the Wheeler and Callahan method — the lower eyelid was in the correct position, changing the direction of tension of the circular muscle and the Riolan’s muscle, creating a duplicate of the muscles. The retractor was strengthened, which ensured the correct position of the eyelid. In 16 cases in recurrent entropion and the presence of blepharospasm caused by corneal changes, surgery was performed according to the Meek method. In the early period, in all cases, hyper effect was observed. In the late period, the hyper effect persisted in 4 cases (25.00 %), but the patients refused reoperation.Conclusions. Determination of the parameters of the lower eyelid state during examination makes it possible to identify the reasons for the development of entropion, the presence of a spastic component MRI or CT examination allows assessing the condition of the eyelid retractor objectively. In patients with spastic entropion, Wheeler and Kallahan surgeries that eliminate the spastic component provide a stable result. In patients with spastic recurrent entropion, accompanied by blepharospasm, the Meek’s surgeries in all cases provide a stable result. The disadvantage of this operation is the presence of hyper effect in 100 % of cases in the early period, which persisted in the late postoperative period in 25 % of cases.

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Purpose. To analyze the efficacy of the lower eyelid eversions surgical treatment.Patients and Methods. We have analyzed the outcomes of treating patients with severe lower eyelid eversion during 2013–2019 — 153 patients, 156 operations. The patients were divided into 4 groups: atonic and paralytic eversion (109 eyes), traumatic tearing of the lower eyelid (8 eyes), cicatricial ectropion (28 eyes) and mechanical ectropion (in tumors) of the lower eyelid (11 eyes). The following surgeries were performed: duplicature surgery by Willer; by Kuhnt-Szymanowski; resection of the framework structure of the lower eyelid with fixation to the eyelid ligaments; implantation of various materials based on the orbital margin; sling to the eyelid ligaments; free skin plasty; local flaps; excision of tumors with one-stage reconstructive plastics.Results. Postoperatively the improvement was observed in all cases. The lower eyelid eversion was eliminated. There were no any complications. The efficacy criteria was the level of the eyelid margin height with regards to limbus, absence or reduction of lagophthalmus. “Good” result — symmetrical width of the eyelid fissure, absence of lagophthalmus was achieved in 100 % of cases in groups IA and II, in 28.12 % — in group IB, in 71.43 % — in group III, in 63.63 % — in group IV. “Satisfactory” result — the difference in the eyelid fissure width was 1.0–2.0 mm, absence or reduction of lagophthalmus was achieved in 65.62 % of cases in group IB, in 21.43 % — in group III, in 27.28 % — in group IV. “Unsatisfactory” result — the difference in the eyelid fissure width was more than 2.0 mm, the presence of lagophthalmus was achieved in 6.25 % of cases in group IB, in 7.14 % — in group III, in 3.33 % — in group IV.Conclusions. When operating the lower eyelid eversion it is possible to achieve good result. The pathogenically based combined methods of surgical treatment are the most effective. In case of traumatic tearing of the lower eyelid, we need to restore the lacrimal duct. In cicatricial ectropion it is possible to achieve engraftment of the skin graft, elimination of eversion and lagophthalmus. In mechanical eversion (due to eyelid tumors) it is necessary to perform radioexcision of the neoplasm with a single-stage reconstructive plastic surgery of the eyelid.