الفهرس 
Surface anatomyOnly 14 pages are availabe for public view
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Abstract
Involutional entropion is a condition that commonly affects old population disturbing their life style and diminishing their capabilities due to lacrimation, redness, foreign body sensation and/ or discharge. Lack of care, ignorance or bad general health condition which are common findings in these patients predispose the occurrence of keratitis and corneal ulcer which are serious complications that lead to vision loss.
Involutional entropion symptoms are relieved by medical preparations as artificial tears and ointment. Compliance, adaptation and progression of entropion limit the use of these preparations. In addition, an outpatient method that gives a rapid temporary help to patients is botulinum toxin injection, whose effect ranges from 8 to 14 weeks. An extra botulinum toxin injection lengthens the duration up to 36 weeks.
Surgery is a permanent solution that cures involutional entropion. Most authors agree that there are three elements responsible for involutional entropion: lower-eyelid laxity, attenuation of the lower-eyelid retractors, and overriding of the orbicularis oculi muscle. Therefore, a definitive procedure should address all these three elements. The eyelids should be shortened horizontally; the lower-eyelid retractors should be fortified or reinserted; and the orbicularis oculi muscle should be attended to, either weakening it or creating a scar barrier under the tarsus to prevent overriding of the preseptal portion.
Many surgical procedures have been published. Some repairs were of temporary results so taking the surgical risk with no evident different result from medical preparations. Retractors’ repair procedure addresses all the three main elements of interest for entropion repair. Primarily it had been done using anterior approach, whose main disadvantage was skin scar and scleral show. The posterior approach has been done through transconjunctival incision and so it is devoid of the skin scar or scleral show disadvantage of the previous anterior approach.