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Tissue Barrier Modifications of a Wheeler II Operation for Entropion

Joseph C. Hill, MD; Fredrick Feldman, MD
Arch Ophthalmol. 1967;78(5):621-623. doi:10.1001/archopht.1967.00980030623012.
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WHEELER,1,2 in 1938, described an operation for the correction of spastic entropion, the basic feature of which is the dissection of a band of orbicularis muscle from the anterior surface of the tarsal plate, overlapping it, and reattaching it to the tarsoorbital fascia just below the tarsus

Hotz,3 in 1879, had described a technique of suturing the upper border of a horizontal skin incision to the lower border of the tarsal plate, in order to pull the margin of the lid downwards and prevent it from inverting.

Hill4 devised an operation which combines the principles of these procedures, modified by the creation of tissue barriers to prevent preseptal orbicularis from moving upwards over the tarsus to the lid edge. These barriers consist of the following: (1) vigorous curettage of the anterior surface of the tarsal plate and of the undersurface of the skin overlying the tarsus in order


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