Surgical Management of Feline Entropion

Entropion, inversion of the eyelid margin, typically presents differently in dogs than in cats.

A categorization for feline entropion has been suggested on the basis of age. In younger cats, entropion may be caused by ocular surface irritation from keratitis, conjunctivitis, corneal ulceration, tear film instability, or corneal sequestrum. In a second form that occurs in older cats, lid laxity or tension can result in entropion.

Various methods of entropion corrections have been described. In a retrospective review of 124 surgically managed feline entropion cases, a combination of Hotz-Celsus (HC) and lateral canthal closure had the highest success rate for resolving entropion in a single procedure. Cats with unilateral entropion often developed entropion in the contralateral eyelid 3 or more months after the first entropion surgery. The cats that presented with unilateral entropion and had contralateral prophylactic surgery never developed entropion in that eye. The authors recommended a combination of HC and lateral canthal closure and prophylactic lateral canthal closure in the contralateral unaffected eye.

CommentaryThis large retrospective study offered valuable information regarding surgical correction for feline entropion. Lessons learned from the study may also be applied to dogs, as a >99% success rate for the surgical correction of feline entropion was demonstrated using the techniques described. While these are excellent results, perhaps the most important aspect involved prophylactic lateral canthoplasty in management of the unaffected eye. Of the contralateral unaffected eyes that had a prophylactic lateral canthoplasty, none subsequently developed entropion in the second eye, whereas 17% of those that did not have the prophylactic procedure eventually developed it. This has been my experience when presented with unilateral canine entropion; the contralateral unaffected eye will benefit from a prophylactic lateral canthoplasty, shortening both eyelids to the appropriate length and preventing future entropion in the unaffected eye.—David A. Wilkie, DVM, MS, DACVO

SourceSurgical management and outcome of lower eyelid entropion in 124 cats. White JS, Grundon RA, Hardman C, et al. VET OPHTHALMOL 15:231-235, 2012.