Fig. 3. Conjunctival lower lid retractor spindle removal. Medial ectropion can be repaired by removal of a conjunctival lower lid retractor spindle from the medial eyelid. (A, cross-sectional view; B, frontal view). A full-thickness suture closure with one or more 5-0 sutures tied over an external bolster of firmly rolled cotton or silicone sponge not only closes the resection of conjunctiva and the lower lid retractors but also advances upwards the anterior lamella increasing the inversion of the punctum. (C, cross-sectional view; D, frontal view). (From Collin JROC: A Manual of Systematic Eyelid Surgery. Edinburgh: Churchhill Livingstone, 1982:31.)