title: Orbicularis oculi muscle tightening for involutional entropion.
abstract: OBJECTIVE
  To describe a novel technique for involutional entropion (IE) correction and present a retrospective case study.
  
  
  METHODS
  The entropion eyelid was corrected by repairing the thin preseptal orbicularis oculi muscle (OOM) of the lower eyelid. Patients underwent correction with this method from 2005 to 2014 and were followed up for 2 years postoperatively. They were evaluated retrospectively with chart review (operation time, recurrence rate, operator years of experience as a plastic surgeon, etc.). Risk factors for recurrence were analyzed.
  
  
  RESULTS
  Fifty-six patients (70 eyelids) were evaluated. The mean operation time was 37.6 min. Postoperative ectropion (over-correction) was observed in 1 patient (1.4%); a local skin flap was performed for this patient. There was recurrence of entropion in 4 patients (5.7%). These 4 patients with recurrent entropion underwent repeat surgery with the same method and achieved good eyelid position. No risk factors were found in this study.
  
  
  CONCLUSIONS
  We consider IE to be mainly caused by the protrusion of orbital fat. The aim of this procedure was to reduce the orbital fat protrusion with OOM tightening. Advantages of this method are that it is technically easy, it is minimally invasive, operative times are short, recurrence rates are low, and esthetic outcomes are good.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan. Electronic address: hnemoto@med.showa-u.ac.jp.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Nemoto
authors.affiliation: Department of Plastic and Reconstructive Surgery, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan.
authors.forename: Tomoichiro
authors.initials: T
authors.lastname: Togo
authors.affiliation: Department of Plastic and Reconstructive Surgery, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Maruyama
authors.affiliation: Department of Plastic and Reconstructive Surgery, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan.
authors.forename: Kenta
authors.initials: K
authors.lastname: Miyabe
authors.affiliation: Department of Plastic and Reconstructive Surgery, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan.
authors.forename: Seiko
authors.initials: S
authors.lastname: Nakae
authors.affiliation: Department of Plastic and Reconstructive Surgery, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan.
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Sumiya
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004774:Entropion / Q000601:surgery*; D005152:Facial Muscles / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D061646:Operative Time; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies
keywords: Involutional entropion; Minimally invasive; Orbicularis oculi muscle; Pathogenesis; Surgical treatment; Therapy