The pathophysiologic changes that lead to involutional entropion are discussed. The Quickert entropion operation gives good results because it rectifies the effect of enophthalmos; it restricts the upward movement of the preseptal muscle; it repairs the relaxation or disinsertion of the lower eyelid retractors; and it corrects the buckling of the upper tarsal border. Using this procedure, the recurrence rate of 3.7% is comparable with that of other procedures.