title: Involutional entropion: risk factors and surgical remedies.
abstract: OBJECTIVE
  To review current surgical practices for the repair of lower eyelid involutional entropion with a focus on recent studies.
  
  
  RESULTS
  A shorter axial length, which may be interrelated with exophthalmometry, correlates with involutional entropion. Although it is known Asian eyelids more frequently develop involutional entropion, there is greater awareness of customized surgical approaches. Minimally invasive techniques for strengthening the action of lower eyelid retractors, such as everting sutures and transconjunctival approaches, continue to be refined and studied. Such surgery is efficacious in patients who do not have horizontal laxity. However, there is consistent evidence that in the presence of laxity the recurrence rate is higher if the eyelid is not horizontally tightened.
  
  
  CONCLUSIONS
  By knowing of the demographics and factors associated with involutional entropion, clinicians can have better understanding of the condition and the patients most at risk. There is not sufficient evidence to determine whether a short axial length is an independent-risk factor for entropion. Advances in surgical technique have led to continued interest in minimally invasive approaches. Precision in addressing individual patients' underlying anatomic abnormalities is important.
authors.affiliation: aDepartment of Ophthalmology, University of Hong Kong, Cyberport, Hong Kong bDepartment of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin, USA.
authors.forename: Marcus M
authors.initials: MM
authors.lastname: Marcet
authors.forename: Paul O
authors.initials: PO
authors.lastname: Phelps
authors.forename: Jimmy S M
authors.initials: JS
authors.lastname: Lai
mesh_terms: D004774:Entropion / Q000601:surgery*; D005143:Eyelids / Q000601:surgery; D006801:Humans; D013508:Ophthalmologic Surgical Procedures; D012008:Recurrence; D012307:Risk Factors; D013537:Sutures