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Ophthal Plast Reconstr Surg. 2013 Sep-Oct;29(5):400-2. doi: 10.1097/IOP.0b013e3182a22ad1.

Inverting sutures for tarsal ectropion (the leicester modified suture technique).

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  • 1Lid, Lacrimal and Orbit Service, University Hospitals of Leicester, Leicester, United Kingdom.



To describe a simple technique to correct tarsal lower eyelid ectropion with or without marked eyelid laxity (The Leicester Modified Suture technique).


A retrospective interventional case series of patients undergoing correction of tarsal ectropion with inverting sutures. The study adhered to the principles of the Declaration of Helsinki.


Twenty patients (25 eyelids) met the inclusion criteria. The success of the procedure was assessed by improvement of symptoms, eyelid position, and the need for reoperation. The mean postoperative follow up was 3.6 months (range 2-15 months). Eighteen patients (90%) had a successful outcome, while in 2 patients (10%) the outcome was satisfactory, as there was mild residual eversion of the eyelids. None of the patients required reoperation.


Tarsal lower eyelid ectropion can be surgically challenging to correct via the transconjunctival plication or subciliary reattachment of retractors. This method is simple to use, resulting in an excellent outcome with no tissue dissection. This technique is easy to learn and implement for oculoplastic surgeons at all levels of experience.

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