Lash Ptosis and Entropion after Congenital Ptosis Surgery: Mechanisms and Treatment.

Abstract

Purpose: This perspective proposes a clinically useful framework for understanding upper eyelid lash ptosis and entropion after congenital ptosis surgery, linking potential mechanisms to prevention and management.

Methods: A focused literature review was performed.

Results: Postoperative lash ptosis and entropion likely reflect the differential interplay of multiple biomechanical factors: lamellar imbalance, suboptimal fixation geometry, tarsal buckling, excessive pretarsal dissection, and patient-specific predisposition, rather than a single technical error. Understanding these mechanisms may help surgeons anticipate risk, refine prevention, and tailor surgical management.

Conclusions: Lash ptosis and entropion after congenital ptosis surgery are likely multifactorial complications resulting from altered eyelid biomechanics. A mechanism-based understanding of these conditions may improve surgical planning and intraoperative decision-making. Further biomechanical and clinical studies are needed to validate this framework and optimize preventive and corrective strategies.