Surgical Outcomes of Transconjunctival Entropion Repair for Lower Eyelid Involutional Entropion: A Retrospective Case Series.

Background Involutional entropion is characterized by inward rotation of the lower eyelid due to horizontal lid laxity, eyelid retractor dehiscence, and orbicularis muscle override. Surgical correction is required to address these underlying mechanisms. Transconjunctival entropion repair (TCER) is a comprehensive surgical approach incorporating procedures designed to address the three principal components of involutional entropion. Method A retrospective review was conducted of patients with involutional entropion who underwent TCER under local anesthesia. A standardized technique incorporating lateral canthotomy, inferior cantholysis, reattachment of the lower eyelid retractors, preseptal orbicularis myectomy, lateral tarsal strip, and lateral canthopexy was performed. Demographic data, surgical outcomes, recurrence rates, and postoperative complications were analyzed. Results A total of 22 eyes from 22 patients were included, with a mean age of 76.3 ± 6.0 years. Immediate postoperative resolution of entropion was achieved in all cases. Overall surgical success was achieved in 19 of 22 eyelids (86.4%). Among patients with long-term follow-up (mean duration: 20.4 ± 16.2 months), surgical success was achieved in 15 of 18 eyelids (83.3%). Recurrence was observed in three eyes at two, three, and 49 months postoperatively. No intraoperative or postoperative complications were observed. No visible external scarring was observed in any patient. Conclusion Transconjunctival entropion repair is a comprehensive technique that addresses all underlying mechanisms of involutional entropion, providing good surgical outcomes, a low complication rate, and satisfactory cosmetic results.