Entropion Surgery (Inward Turning Eyelid Repair)

The surgical technique chosen for entropion repair depends on the cause and type of entropion. Common approaches include:

• Lateral Tarsal Strip Procedure: The most widely used technique for age-related (involutional) entropion. A small section of the eyelid is tightened and reattached to the orbital rim to restore horizontal tension, preventing the lid from rolling inward.
• Everting Sutures: Permanent sutures are placed through the eyelid to rotate the lid margin outward. This is a simpler technique often suitable for mild or recurrent spastic entropion.
• Posterior Lamellar Repair (for Cicatricial Entropion): When scarring of the inner eyelid surface is the cause, the scar tissue is carefully released and the lid is reconstructed, sometimes using a mucosal graft to replace the scarred inner lining.
• Jones Procedure / Wies Procedure: Techniques that address the structural and muscular factors contributing to entropion, suitable for selected cases.

Your surgeon will recommend the most appropriate technique following a detailed examination of your eyelid anatomy and the cause of the inturning.

You may be a suitable candidate for entropion surgery if:

• Your eyelid consistently turns inward, causing persistent eye irritation, redness, or tearing.
• The inturning eyelashes are scratching the surface of your eye, putting the cornea at risk of scarring or infection.
• Temporary measures such as lubricating drops or eyelid taping are no longer providing adequate relief.
• You are in reasonable general health, with no uncontrolled medical conditions that would increase surgical risk.
• You have realistic expectations and understand that some swelling is expected during the recovery period.

A detailed consultation with Dr. Moupia Goswami will include an examination of your eyelid position, corneal health, and tear film to confirm whether surgery is the right option for you.

Here is what to expect at each stage of the entropion surgery journey:

Pre-surgery

A thorough consultation including assessment of eyelid laxity, corneal health, and the cause of entropion. Photographs are taken. You may be advised to stop blood-thinning medications in the days before surgery. Arrangements for someone to accompany you home on the day of the procedure are recommended.

On the day of surgery

The procedure is performed under local anaesthesia, usually as a day case. The surgery typically takes approximately 30–45 minutes. Small, precise incisions are made to reposition or tighten the eyelid, and fine sutures are placed. You will be able to go home the same day.

Postoperative period

Mild swelling, bruising, and some discomfort are expected in the first few days. Sutures are usually removed at 14 days. Most patients notice that the eyelid is resting in the correct position immediately after surgery, with the eye feeling significantly more comfortable as swelling settles.

Entropion surgery is most commonly performed under local anaesthesia, which is well-tolerated and allows patients to go home shortly after the procedure. Options include:

Available Options:

• Local Anaesthesia: The eyelid area is numbed with an injection. You remain awake and comfortable throughout the procedure.
• Local Anaesthesia with Sedation: Additional intravenous sedation can be given, providing a more relaxed experience while keeping you responsive.
• General Anaesthesia: Occasionally used for complex repairs or when combined procedures are planned.

Factors Influencing Choice:

• Patient preference and anxiety level
• Complexity of the repair required
• Overall medical history and fitness for anaesthesia

Recovery from entropion surgery is generally smooth and well-tolerated:

Immediate Post-Surgery (First 24 Hours)

Some swelling, bruising, and mild discomfort around the eyelid are expected. Keeping the head slightly elevated and applying a cold compress gently to the area can help. Antibiotic ointment or eye drops will be prescribed to prevent infection and aid comfort.

First Week (Days 1–7)

Sutures remain during this period. Most patients find the eye feels considerably more comfortable as soon as the eyelid is back in its correct position. Avoid rubbing the eye, swimming, or strenuous activity during this period.

Week 2–4

Sutures are removed at 14 days. Residual swelling continues to resolve. Makeup and contact lenses can usually be resumed after about 2 weeks. Light work and daily activities can be resumed from the first week.

Long-Term Outcome

Final results are evident within 4–8 weeks as swelling fully resolves and the eyelid settles. Entropion surgery provides long-lasting correction for the majority of patients.

Entropion surgery delivers both functional and quality-of-life benefits:

• Relief from eye irritation and pain: Eliminating the contact of eyelashes against the eye surface resolves the persistent discomfort that entropion causes.
• Protection of the cornea: Surgery prevents progressive corneal damage, abrasions, and the risk of corneal ulcers or scarring.
• Reduction in tearing and discharge: Many patients experience significant improvement in watery eyes and eye discharge after surgery.
• Improved light sensitivity: Once the corneal irritation resolves, sensitivity to light typically decreases.
• Long-lasting correction: In most patients, surgical repair offers a durable solution, avoiding the need for repeated temporary measures.

Entropion surgery is a well-established procedure with a high success rate. As with any surgery, there are some potential risks to be aware of:

• Temporary swelling, bruising, and discomfort, which resolve within 1–2 weeks.
• Undercorrection or recurrence of entropion, which may require revision surgery in a minority of cases.
• Overcorrection resulting in the eyelid turning slightly outward (ectropion).
• Infection or delayed wound healing, which is uncommon with appropriate post-operative care.
• Scarring at the incision site, which generally becomes imperceptible over time.

Choosing an experienced oculoplastic surgeon significantly reduces the risk of complications. Dr. Moupia Goswami will discuss all risks and what to watch for during your recovery.