Lower eyelid retractor (white-line) advancement to correct tarsal ectropion

Abstract Objective To describe a modification of trans-conjunctival, lower eyelid retractor advancement to correct tarsal ectropion. Design A retrospective case review. Participants Consecutive patients with lower eyelid tarsal ectropion. Methods Cases of lower eyelid tarsal ectropion, surgically corrected by advancement of inferior retractor to the lower border of tarsus via a transconjunctival approach, were identified. Lateral tarsal strip was also performed simultaneously in all cases. Results Twenty patients (25 eyelids) were included in this study. There were 19 primary lower eyelid tarsal ectropion and 6 recurrent tarsal ectropion. Complete resolution of tarsal ectropion was achieved in all patients postoperatively. Mean follow-up was 8.4 months (range 1–36 months). There were no cases of overcorrection, recurrent ectropion, suture abscess, wound dehiscence, or inferior fornix shortening after surgery. Conclusions Visualization of the lower eyelid retractor (white-line) and advancement to the inferior border of tarsus through a transconjunctival approach is effective in correcting both primary and recurrent cases of tarsal ectropion. This can be performed through a small conjunctival incision in the middle third of the lower eyelid, without the need for any excision of tissue or suture loop tie on the skin surface.