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Arch Plast Surg. 2018 Nov;45(6):525-533. doi: 10.5999/aps.2018.00836. Epub 2018 Nov 15.

Algorithm for the management of ectropion through medial and lateral canthopexy.

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Department of Plastic and Reconstructive Surgery, Korea University College of Medicine, Seoul, Korea.



Patients with ectropion experience devastating symptoms. Therefore, the prevention and management of this condition are of utmost importance. To treat ectropion, it is important to perform medial and lateral canthopexy in an effective way. In this study, we propose a comprehensive algorithm for the prevention and management of ectropion based on a new classification of ectropion according to its signs and causes.


Canthopexy was performed in 68 cases according to the proposed algorithm, which starts with a categorization of the types of ectropion and ends with the recommended operative technique. To assess the results, we reviewed clinical preoperative and postoperative photographs. To evaluate improvements in patients' symptoms, we conducted a survey with responses scored on a Likert scale.


None of the patients had scleral show postoperatively. The average patient satisfaction score was satisfied or higher for all symptoms, and the most improved symptom was aesthetic appearance. No major complications were reported.


For the comprehensive management of ectropion, it is crucial to consider both treatment and prevention. Through the simple surgical algorithm proposed in this study, both medically acceptable results and high levels of patient satisfaction were achieved without significant postoperative complications. We recommend using this algorithm for the comprehensive management of ectropion.


Blepharoplasty; Ectropion; Eyelids

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