A 70-year-old man has right lower lid involutional entropion with trichiasis causing corneal abrasion. Everting sutures provide temporary relief. The definitive surgical repair that corrects both horizontal lid laxity and posterior lamellar vertical deficiency is:
- A Weis procedure (transverse tarsal fracture and marginal rotation sutures)
- B Jones procedure (inferior retractor plication with lateral tarsal strip) ✓
- C Quickert-Rathbun sutures alone
- D Wedge resection of lower lid
Correct answer: B. Jones procedure (inferior retractor plication with lateral tarsal strip)
Explanation
Involutional entropion results from three components: overriding pre-tarsal orbicularis, disinsertion of the inferior retractors, and horizontal lid laxity. The Jones procedure combines inferior retractor plication (correcting vertical instability) with lateral tarsal strip (correcting horizontal laxity) and is the most comprehensive surgical repair. Weis (transverse tarsal fracture) and Quickert-Rathbun sutures are temporary or less reliable for combined laxity. Wedge resection alone corrects only horizontal laxity.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.