Involutional lower eyelid entropion: causative factors and therapeutic management

Purpose To summarize proposed causative factors and the outcomes of surgical practices for involutional lower eyelid entropion. Methods We reviewed the literature on proposed causative factors and the outcomes of surgical practices for involutional lower eyelid entropion, searched on PubMed. Results Vertical and horizontal laxities of the lower eyelid, and overriding of the preseptal orbicularis oculi muscle onto the pretarsal orbicularis oculi muscle have been proposed as the major causes of involutional lower eyelid entropion. Treatment procedures have been developed over the years to address one or more of these causative factors. Conclusions Various causative factors and treatment procedures have been advocated to explain and correct involutional lower eyelid entropion. The appropriate procedure is chosen according to the patient's condition, such as the presence of vertical laxity, horizontal laxity, and orbicularis oculi muscle overriding. A combination of these procedures to correct multiple factors further decreases the recurrence rate.