Entropion is a condition in which the eyelid is rolled inward toward the eye. It can occur as a result of advancing age and an imbalance of certain eyelid muscles and tendons. Entropion may also occur because of trauma, scarring, or previous surgeries. Entropion may also rarely occur in children.
A turned in eyelid rubs against the eye, making it red, irritated, painful, and sensitive to light. If it is not treated, the condition can lead to excessive tearing, mucous discharge and scratching or scarring of the cornea. A chronically turned in eyelid can result in acute sensitivity to light and may lead to eye infections, corneal abrasions, or corneal ulcers. If entropion exists, it is important to have the condition treated before permanent damage to the eye occurs.
Selecting the right surgeon for ectropion surgery is critically important. When performing surgery in one of the most delicate skin areas of your entire body that also has one of the most intricate anatomies, the pool of surgeons qualified to perform such a procedure shrinks dramatically.
When dealing with any problem near the eye, you need to see a physician trained as an ophthalmologist. Many doctors are not comfortable working in that area because of the specialized anatomy and will refer you to an ophthalmologist anyway. Additionally, because this is an extraocular procedure (outside of the eye) as opposed to an intraocular procedure (inside of the eye), the best choice for entropion surgery is an oculoplastic surgeon (also known as an ophthalmic plastic and reconstructive surgeon).
A well-trained oculoplastic surgeon can combine their knowledge of the eye with the artistic expertise of a plastic surgeon. You need a doctor that can ensure that the procedure is done correctly, but also won’t leave an unsightly scar near your eyes. Dr. Liu is an oculoplastic surgeon and has completed an ASOPRS fellowship, making her one of the most highly qualified oculoplastic surgeons in North America.
Entropion surgery can be performed under local anesthesia in Dr. Liu’s procedure room or under sedation at an off-site surgery center, but only in very rare cases would general anesthesia be used.
Dr. Liu begins by making an incision by the outer corner of your eye. She then tightens the tendon that supports the lower eyelid and attaches to the bony orbit. The lower eyelid may or may not be shortened depending on how loose it is. Sometimes a skin incision is also made below the lower eyelashes and sutures are placed to turn the eyelid outward. The corner of the eye is then reformed and the skin incisions are closed with dissolvable sutures that do not need to be removed in the office.
Rarely, if there is a lot of scarring inside the eyelid, Dr. Liu may need to place a graft from inside your mouth or from an acellular material to reconstruct the eyelid. If this is the case, the eyelids may need to be closed and a patch placed over the eye for approximately 1 week.
The specific techniques that Dr. Liu uses will be selected based on your needs. Because Dr. Liu has such specialized training, she has access to a number of techniques that are not utilized by most other doctors, and she will customize these techniques to get the best outcome.
Entropion surgery typically takes about 1-2 hours from start to finish.
Entropion surgery may have a scar at the incision, but it is usually not obvious. Dr. Liu makes the incision in the lateral upper lid crease, next to the eye, inside the eyelid, or right underneath the lower lid lashes. Non-specialized surgeons typically have results with more visible scarring.
Entropion surgery is generally a very safe procedure. When considering any eyelid surgery, it is important to inform your surgeon of any abnormalities of your eyes, vision, or your general medical health.
It is important to remember that while all surgery carries some risks, even when performed by the most highly trained surgeon and at the best facilities. Below are some of the more common risks associated with eyelid surgery:
The likelihood of serious complications arising from the procedure is typically influenced by both the surgeon’s skill as well as the patient’s individual response to the eyelid surgery. Certain severe risks or complications can be avoided by cooperating fully and completely following your surgeon’s instructions. With patience, a willingness to cooperate, and a qualified surgeon, the complications of eyelid surgery and any associated risks can be dramatically reduced.
Surgery should be scheduled for a time when you can relax for at least 1-2 weeks. It is important to avoid any strenuous activity, heavy lifting, or bending down during this time to avoid complications and to promote the best healing. It is also important to avoid taking any blood thinning medications around the time of surgery. If you are on a blood thinning medication due to a specific medical condition, you will need to discuss this with Dr. Liu and your primary care physician prior to stopping any medication. Dr. Liu’s staff will review a list of common medications, supplements and vitamins that can cause your blood to be thinner.
Please note that Dr. Liu expects to see patients back in the office a few days after a procedure to ensure that the healing process is going as expected and that you are on track for a good result. Do not plan any travel immediately after your procedure.