Fig. 90b.—Correction of Partial Ectropion. (Author’s case.)
Complete Ectropion
Dieffenbach Method.—In complete ectropion the entire lid between the canthi is included in the V-shaped incision just mentioned ([Fig. 91]) and the flap is sutured as shown in [Fig. 92].
In crowding up the detached flap the palpebral border must be overcorrected, since the contractions following union will reduce the effect even to the extent of necessitating later minor operations.
Fig. 91. Fig. 92.
Complete Ectropion, Dieffenbach Method.
To prevent this contraction the palpebral fissure may be united after the correction is made by fine sutures, which are removed in several weeks (Plessing). This is rather uncomfortable for the patient, but there is no question as to the efficacy of the method. A shield can be worn over the eye operated upon after the incisions have united until the lids are separated. This relieves the discomfort of the patient to some extent, while the constant conscious strain to open the eye is greatly overcome by the mere knowledge of the presence of the shield.
If the position, or the extent of the deformity, does not permit of the Dieffenbach method, the following may be employed: