Correction of Involutional Entropion Using Ciliary Rotating Suture Combined with Skin-orbicularis Oculi Muscle Excision

Purpose: To evaluate the clinical efficacy of ciliary rotational suture combined with skin-orbicularis oculi muscle excision in the management of involutional entropion.Methods: Between April 2022 and January 2024, 41 eyes of 27 patients with involutional entropion underwent surgical correction. Three eyes with concomitant trichiasis received adjunctive hyfrecation. Patients with severe horizontal lower eyelid laxity were excluded. A subciliary incision was made, and the subcutaneous tissue above the incision was sutured to the tarsal plate using 7-0 nylon to achieve outward rotation of the eyelashes. The skin and orbicularis oculi muscle along the incision line were carefully separated, after which the overlapping portions were excised, and the skin was subsequently sutured.Results: During a mean follow-up of 20.8 months, no recurrences were observed. One eye developed ectropion intraoperatively, which was successfully corrected with a lateral tarsal strip procedure. The remaining 40 eyes (97.6%) demonstrated satisfactory cosmetic and functional eyelid positions without overcorrection. Among the 13 patients who underwent unilateral surgery, no cosmetic issues, such as bilateral asymmetry, were reported.Conclusions: The ciliary rotational suture combined with skin-orbicularis oculi muscle excision yielded favorable outcomes in patients with involutional entropion who did not exhibit severe horizontal eyelid laxity.