A 68-year-old man has lower eyelid inturning causing corneal irritation. The tarsal plate appears normal in size. He has significant horizontal lid laxity on snap-back test. The MOST appropriate surgical correction is:
- A Wedge resection (pentagonal block resection) ✓
- B Everting sutures (Jones procedure)
- C Weis procedure with lateral canthal tightening
- D Tarsal fracture procedure
Correct answer: A. Wedge resection (pentagonal block resection)
Explanation
This patient has involutional entropion with significant horizontal lid laxity (positive snap-back test). Wedge or pentagonal block excision shortens the lid and corrects horizontal laxity, the primary pathology. Everting sutures (Jones) provide temporary correction without addressing laxity and are prone to recurrence. The Weis procedure (full-thickness lid split with everting sutures) is used when laxity is absent or minimal. Lateral canthal tightening alone is insufficient when the entire horizontal lid is lax.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.