A combination of modified Kuhnt-Szymanowski and Celsus-Hotz techniques for correction of entropion and overlong lower eyelids in dogs (40 eyes)

Vet Ophthalmol. 2025 Mar;28(2):114-123. doi: 10.1111/vop.13084. Epub 2023 Mar 22.

Abstract

Purpose: To describe a surgical approach to correct entropion and overlong lower eyelids in dogs by combining the Celsus-Hotz with the modified Kuhnt-Szymanowski technique.

Methods: Medical records of patients undergoing the described surgical procedure were reviewed. A semilunar-shaped piece of lower eyelid was excised and combined with an angled incision at the most lateral aspect of the wound. Adjacent to this incision a skin flap was mobilized to expose the subcutaneous tissue in the ventral aspects. A four-sided wedge resection was used to shorten the lid margin in variable positions. Following closure of the eyelid margin wedge resection, a wedge of equal width was removed from the lateral skin flap. Skin and subcutaneous tissues were closed in a routine fashion.

Results: All surgeries were performed by an ECVO diplomate or resident. The surgery was performed unilaterally in four and bilaterally in 18 dogs. Most common breeds were English Bulldog (n = 7), Saint Bernard (3), Rottweiler (2) and Cane Corso Italiano (2). Median age was 22 months (range 5-100 months). Median follow-up was 30 days (range 9-987 days). A single surgical procedure was sufficient to correct the entropion in 97.5% (39/40) of eyes.

Conclusion: The combination technique described is a suitable surgical procedure to simultaneously correct lower lid entropion and excessive eyelid length, with the added benefits of a stepped wound closure and a flexible lid margin wedge positioning.

Keywords: Celsus–Hotz procedure; Hotz–Celsus procedure; Kuhnt–Szymanowski technique; canine; entropion; overlong lower eyelid.

MeSH terms

  • Animals
  • Dog Diseases* / surgery
  • Dogs
  • Entropion* / surgery
  • Entropion* / veterinary
  • Eyelids* / surgery
  • Female
  • Male
  • Ophthalmologic Surgical Procedures* / methods
  • Ophthalmologic Surgical Procedures* / veterinary
  • Retrospective Studies