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What Is Lateral Tarsal Strip Surgery?

Lateral tarsal strip surgery is an eyelid tightening procedure that corrects horizontal lower eyelid laxity. The surgeon creates a firm strip from the lower eyelid tarsus and reattaches it at the outer corner to restore lid tension and position. It is commonly used to treat involutional ectropion, some forms of entropion, punctal malposition, and exposure symptoms. The procedure is often combined with other eyelid repairs when needed.

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What Is Lateral Tarsal Strip Surgery?

Lateral tarsal strip surgery is an eyelid tightening procedure that corrects horizontal lower eyelid laxity. The surgeon creates a firm strip from the lower eyelid tarsus and reattaches it at the outer corner to restore lid tension and position. It is commonly used to treat involutional ectropion, some forms of entropion, punctal malposition, and exposure symptoms. The procedure is often combined with other eyelid repairs when needed.

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Who May Need This Procedure

Lateral tarsal strip surgery is typically recommended when lower eyelid laxity causes symptoms or visible malposition.

  • Lower eyelid ectropion with tearing and exposure
  • Lower eyelid entropion related to laxity
  • Punctal eversion contributing to watery eyes
  • Incomplete lid closure or exposure-related irritation in selected cases

How It Works

The procedure increases horizontal lid tension and stabilizes the outer corner.

  1. A small outer corner incision is made and the lower lid tissues are released as needed.
  2. A tarsal strip is fashioned from the lower lid and prepared for fixation.
  3. The strip is anchored to the lateral orbital rim periosteum to achieve proper height and tension.

Proper tension is important to avoid overcorrection or persistent laxity.

Recovery and Aftercare

Redness, swelling, and bruising are common early and usually improve over 1 to 2 weeks. Lubrication may be recommended while the eyelid position stabilizes, especially if exposure symptoms were present before surgery. Most patients can resume routine activities within days, but heavy lifting, swimming, and eye rubbing are typically avoided temporarily. Follow-up visits confirm lid position and punctum alignment.

Risks and Outcomes

Most people have improved lid position and reduced exposure or tearing when the underlying cause is addressed. Risks can include infection, bleeding, scarring, and temporary irritation. Undercorrection or overcorrection can occur and may require revision in some cases. Seek prompt care for increasing pain, spreading redness, thick discharge, or vision changes.

FAQs on Lateral Tarsal Strip Surgery

Is lateral tarsal strip surgery painful?

Discomfort is usually mild to moderate because local anesthesia is used during the procedure. After surgery, soreness and tightness are common for a few days and typically improve with prescribed care. Severe pain is not expected and should be reported.

Will there be a visible scar?

The incision is typically placed at the outer corner where it tends to heal well and can be subtle. Scar visibility varies by skin type and healing. Your surgeon can explain incision placement and scar care.

How long does it take to heal?

Most swelling and bruising improve within 1 to 2 weeks, while final lid position can continue to refine over several weeks. Your follow-up schedule helps confirm stable results. Healing can take longer if multiple procedures are done together.

Can it be combined with other eyelid procedures?

Yes. It is commonly paired with procedures that address medial eyelid issues, punctal position, or vertical lid laxity. Combining procedures can improve overall function when more than one factor is causing the eyelid problem.

References

The Lateral Tarsal Strip for Correction of Ectropion. American Academy of Ophthalmology. https://www.aao.org/clinical-video/lateral-tarsal-strip-correction-of-ectropion. Date Accessed February 6, 2026.

Ectropion Correction Using Lateral Tarsal Strip and Myocutaneous Flap. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC8226573/. Date Accessed February 6, 2026.

Lateral Tarsal Strip Procedure for Correction of Involutional Ectropion and Entropion: A Retrospective Analysis of 85 Patients. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC9440658/. Date Accessed February 6, 2026.

Techniques for Occult Ectropion Repair: A Review. Frontiers in Ophthalmology. https://www.frontiersin.org/journals/ophthalmology/articles/10.3389/fopht.2022.821489/full. Date Accessed February 6, 2026.

Lateral Tarsal Strip Procedure: Background and Technique. ScienceDirect. https://www.sciencedirect.com/science/article/pii/S0039625724000232. Date Accessed February 6, 2026.