A 65-year-old man has involutional entropion of the lower eyelid. The lid margin is turned inward, and there is horizontal lid laxity with a positive snap-back test. The orbicularis muscle shows no hypertrophy or cicatrization. Which surgical procedure directly addresses the underlying pathophysiology?
- A Transverse everting suture (Quickert-Rathbun)
- B Lower lid retractor reattachment with horizontal lid shortening ✓
- C Wies marginal rotation
- D Full-thickness skin graft
Correct answer: B. Lower lid retractor reattachment with horizontal lid shortening
Explanation
Involutional entropion results from horizontal lid laxity, lower lid retractor dehiscence, and overriding preseptal orbicularis. The definitive correction addresses all components: retractor reattachment corrects the inward rotation, and horizontal lid shortening (lateral tarsal strip) corrects laxity. Transverse everting sutures are temporary. Wies rotation is for mild cases without significant laxity. Skin grafts are for cicatricial entropion with anterior lamellar shortage.
Reference: Oculoplastic Surgery: The Essentials, 1st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.