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

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.