Tarsotomy for the treatment of cicatricial entropion with trichiasis.

Transverse tarsotomy and lid margin rotation is a simple procedure that is effective in repositioning the entropic lid margin without requiring external incisions or grafting. We report the results of this procedure in 81 eyelids of 58 patients with cicatricial entropion and trichiasis who were followed up for a minimum of 6 months after surgery. Fifty-nine (94%) of sixty-three eyelids with mild to moderate cicatricial entropion were cured with this procedure. Patients with severe cicatricial entropion had a lower success rate with initial tarsotomy (55%), but in these patients the procedure had minimal complications and repeating the operation resulted in a higher success rate. Tarsotomy and lid margin rotation produces excellent cosmetic and functional results when used to treat patients with mild to moderate cicatricial entropion. In cases of more severe cicatricial entropion, we still recommend it as the initial procedure after which more complex modalities may be used if needed.