Ectropion is not uncommon, and involves the lower lid only in the great majority of cases. It may be partial or complete, according to the extent of cicatricial changes in the skin.
Fig. 89.—Dieffenbach Method.
Partial Ectropion
For the correction of partial ectropion a V-shaped incision is made on the lid with the base of the triangle, including the maximum eversion, as in [Fig. 89], a.
Fig. 90a.—Correction of Partial Ectropion. (Author’s case.)
The incisions are made downward from the tarsal border, just below the lashes, and converge to a point. The flap included therein is carefully dissected up, dividing all the scar adhesions, and is pushed upward until the tarsal border at the seat of the defect is overcorrected in this position. The incisions are united with No. 1 twisted-silk structures to form the letter Y, as shown in [Fig. 89], b.
As the lid has usually become elongated from prolonged eversion, a small, triangular piece of skin may be excised at the outer end of the lid, with its base turned upward. In bringing the two sides together in linear form, horizontal traction is made along the tarsal line, which aids much in bringing about the desired result.
In the case shown in [Fig. 90a] the ectropion was the result of the application of nitric acid or caustic potash for the removal of a nevus. It was corrected by the method just described, the result being shown in [Fig. 90b].