Involutional entropion: a simple and stable repair

A simple technique for repair of involutional entropion is described. A 4 x 20 mm strip of cartilage is removed from the concha of the ear and placed in the lower lid, deep to the orbicularis muscle. Over the past 6 years, I have performed this procedure on 15 patients. Fourteen patients had an excellent result; one patient required a secondary lateral wedge resection. There have been no recurrences. The tarsal plate of the lower eyelid appears to soften and shrink with advancing age. As the tarsus shrinks, the lid becomes less rigid and the margin tends to roll inward. Creating a neotarsus out of ear cartilage provides a simple and stable repair for involutional entropion because it restores the structural rigidity of the lower lid. The operative procedure is technically simple. Its long-term effectiveness confirms the view, not widely held, that one primary cause of involutional entropion is a shrunken and atrophic tarsal plate.