A patient presents with a lower eyelid that turns inward, causing the lashes to rub against the cornea. The medial canthal tendon is lax and there is horizontal lid laxity. The most appropriate surgical procedure to correct this involutional entropion is:
- A Horizontal lid tightening (lateral tarsal strip procedure) ✓
- B Quickert-Rathbun sutures (rotation sutures)
- C Jones' procedure (inferior retractor reinsertion)
- D Wies procedure (transverse lid margin split)
Explanation
In involutional entropion, the predominant mechanism is horizontal lid laxity with dehiscence or disinsertion of inferior retractors and overriding of the preseptal orbicularis. The lateral tarsal strip procedure corrects horizontal laxity effectively and is the standard definitive surgical repair. It addresses the primary pathological mechanism. Quickert-Rathbun and Wies procedures are simpler rotational approaches but do not correct horizontal laxity, leading to higher recurrence. Full correction often requires combining horizontal tightening with inferior retractor reinsertion.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.