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BACKGROUND The accepted standard for the correction of involutional entropion has not been well established. This is our search for the reasonable answer for our dilemma. For the correction of involutional entropion, we have applied the modified Kuhnt-Szymanowski-Smith method. It brought the best result compared with other various procedures. METHODS This report is a retrospective interventional case series of all consecutive patients with the lower-eyelid involutional entropion. They were operated exclusively by the same author with the modified Kuhnt-Szymanowski-Smith method, which was originally reported for the corrective procedure for ectropion. RESULTS In total, 27 patients underwent surgical repair with the modified Kuhnt-Szymanowski-Smith method. There were 15 men and 12 women with a mean age of 77 years (range, 70-91 years). There was no case of recurrence following the primary procedure during 20 months of the mean follow-up period (18-36 months). CONCLUSIONS From our experience, this is one of the procedures to be considered for involutional entropion. It is not only safe, simple, and effective but also requires short operative time.

This study was undertaken to determine whether periosteum from different bone sources in a donor results in the same formation of bone and cartilage. In this case, periosteum obtained from the cranium and mandible (examples of tissue supporting intramembranous ossification) and the radius and ilium (examples of tissues supporting endochondral ossification) of individual calves was used to produce tissue-engineered constructs that were implanted in nude mice and then retrieved after 10 and 20 weeks. Specimens were compared in terms of their osteogenic and chondrogenic potential by radiography, histology, and gene expression levels. By 10 weeks of implantation and more so by 20 weeks, constructs with cranial periosteum had developed to the greatest extent, followed in order by ilium, radius, and mandible periosteum. All constructs, particularly with cranial tissue although minimally with mandibular periosteum, had mineralized by 10 weeks on radiography and stained for proteoglycans with safranin-O red (cranial tissue most intensely and mandibular tissue least intensely). Gene expression of type I collagen, type II collagen, runx2, and bone sialoprotein (BSP) was detectable on QRT-PCR for all specimens at 10 and 20 weeks. By 20 weeks, the relative gene levels were: type I collagen, ilium >> radial ≧ cranial ≧ mandibular; type II collagen, radial > ilium > cranial ≧ mandibular; runx2, cranial >>> radial > mandibular ≧ ilium; and BSP, ilium ≧ radial > cranial > mandibular. These data demonstrate that the osteogenic and chondrogenic capacity of the various constructs is not identical and depends on the periosteal source regardless of intramembranous or endochondral ossification. Based on these results, cranial and mandibular periosteal tissues appear to enhance bone formation most and least prominently, respectively. The appropriate periosteal choice for bone and cartilage tissue engineering and regeneration should be a function of its immediate application as well as other factors besides growth rate.