Lid retractors desinsertion in acquired ptosis and involutional lower lid entropion: surgical implications

Background: An association exists between upper and/or lower lid retractors ' desinsertion and acquired ptosis and/or involutional lower lid entropion. Method: By highlighting the similarities that exist in the anatomy of the u pper and lower lid retractors a possible pathophysiological mechanism leadi ng to acquired ptosis and involutional lower lid entropion is suggested. As a logical consequence, in case of desinsertion, it is proposed to reattach the lid retractors to the tarsus. Results: With this simple "physiological" surgical approach it is possible to treat with success a great majority of acquired ptosis and/or involution al lower lid entropion. Conclusion: Repairing upper and/or lower lid retractors' desinsertion can c ure acquired ptosis and/or involutional lower lid entropion.