The dermatochalasis of the lower eyelid: A possible aetiology for involutional entropion

Abstract

Purpose To analyze the relationship between dermatochalasis and the orbicularis retaining ligament (ORL) and their effect on involutional entropion. Methods Ninety-two eyelids of 68 patients with involutional entropion underwent surgery to remove the prolapsing fat, plicate the lateral canthal tendon or use a lateral tarsal strip procedure, advance the retractor, resect the excess skin with OOM and tighten the OOM by securing the OOM flap to the periosteum, and had a postoperative follow-up of 12 ~ 18 months. Results Eighty-eight of 92 eyelids had a satisfactory outcome with normal eyelid positioning and pleasing cosmetic results. Four eyelids showed ectropion, but all of them improved in three months. No recurrence was observed in this study. Conclusions The dermatochalasis may be an aetiology of involutional entropion. The relaxed skin could be retracted upward by the ORL, and the skin is then rolled over the superior tarsal border and pressed against the globe. Our procedure addressed most factors and is a useful technique for involutional entropion.