Variations on the theme of involutional entropion and the Quickert repair.

The late Marvin Quickert originated a lower lid entropion repair successful especially in recurrent cases. Probable reasons for its success is correction of all three main conditions predisposing to entropion, namely increased horizontal length, excessive vertically mobile preseptal orbicularis, and lax retractors, whereas other entropion procedures correct only one or two factors. A bridge flap of lid is created by an incision at the base of the tarsus, and this is then transected vertically in its outer third. The amount of horizontal redundance determined, a rectangle of full thickness lid is excised, and the ends reapproximated. Wies type sutures are placed approximating superior anterior lamella to inferior posterior lamella. Redundant skin is excised laterally and the entire skin incision closed. A Wies procedure resulting in immediate ectropion can easily be converted to this procedure.