Lateral palpebral tendon repair for lower eyelid ectropion.

A dehiscence of the lateral palpebral tendon may cause laxity of the eyelid and result in lower eyelid ectropion. In this study lateral palpebral tendon reconstruction was performed on 45 eyelids with ectropion and lateral palpebral tendon laxity. A periosteal flap from the lateral orbital rim was used to replace the attenuated tendon. After a mean follow-up of 16 months, 91% (41 of 45) of the eyelids had acceptable cosmetic and functional results. Included in this group were 16 eyelids with mild residual ectropion. The use of a periosteal flap to replace an attenuated lateral palpebral tendon has several advantages. The periosteal flap is readily available, strong, and autogenous. The lateral canthus is pulled posteriorly and laterally keeping the eyelid against the globe. Lastly, the procedure may be repeated or combined with other ectropion procedures.