Ectropion is frequently encountered in plastic surgery. A variety of etiologies exist, but tarsal ectropion, defined as complete eversion of the tarsal plate and its overlying conjunctiva, is rarely considered. First described in 1960 by Fox,
1this variant was initially attributed to pre-septal orbicularis oculi spasm or tarsoligamentous relaxation. However, subsequent investigators determined that the true etiology involved lower lid retractor disinsertion on the tarsal plate.
- Fox S.A.
Marginal (tarsal) ectropion.
Arch Ophthalmol. 1960; 63: 660-662
2We present a case of chronic right lower lid ectropion in a 66-year-old male. Through understanding of eyelid anatomy, especially that of the lower eyelid retractors, tarsal ectropion was correctly identified in our patient preoperatively. A repair including correction of retractor disinsertion on the tarsus was planned, and given our patient’s degree of lower lid delamination and mobilization, we also proceeded with bilateral lower lid blepharoplasty with canthal and lower lid soft tissue support. Ultimately, we were able to achieve an improved aesthetic appearance for our patient, along with resolution of his symptoms.
- Tse D.T.
- Kronish J.W.
- Buus D.
Surgical correction of lower-eyelid tarsal ectropion by reinsertion of the retractors.
Arch Ophthalmol. 1991; 109: 427-431
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- Marginal (tarsal) ectropion.Arch Ophthalmol. 1960; 63: 660-662
- Surgical correction of lower-eyelid tarsal ectropion by reinsertion of the retractors.Arch Ophthalmol. 1991; 109: 427-431
- The microscopic anatomy of the lower eyelid retractors.Arch Ophthalmol. 1982; 100: 1313-1318
- The lower eyelid retractor consists of definite double layers.Ophthalmol. 2006; 113: 2346-2350
- Physiology of the lower eyelid retractors: tight linkage of the anterior capsulopalpebral fascia demonstrated using dynamic ultrafine surface coil MRI.Ophthalmol Plast Reconstr Surg. 1994; 10: 87-91
- Ectropion of the lower eyelid secondary to Müller’s muscle-capsulopalpebral fascia detachment.Am J Ophthalmol. 1978; 85: 814-817
- Primary transcutaneous lower blepharoplasty with routine lateral canthal support: a comprehensive 10-year review.Plast Reconstr Surg. 2008; 121: 241-250
Published online: July 18, 2011
Accepted: June 21, 2011
Received: June 10, 2011
© 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.