SUTURES have been used for the correction of lower eyelid entropion since the time of Hippocrates1 who placed a suture through a horizontal fold of skin just beneath the lid margin. Guillard, Graefe and Arlt1 also used sutures in the anterior lid layers (skin and orbicularis muscle) to correct the inverted lid margin. Snellen and Stellen1 proposed techniques for the placement of two or three double armed sutures through the entire lid thickness. Snellen passed the suture through conjunctiva, lower lid retractors, and orbicularis muscle at the level of the lower fornix. The suture was then passed superiorly and brought out through the skin 2 mm inferior to the cilia. Stellen modified the technique by passing the needle superiorly between the tarsus and orbicularis muscle. Both tied their sutures over bolsters.
This report describes a technique for placement of sutures through the full thickness of the lower lid.