Objective: To evaluate the results and activity of the modified technique of tarsoconjunctival diamond excision and horizontal shortening (Lazy-T) in patients with medial involutional ectropion. Methods: Eighty two eyes of 59 patients who had a modified Lazy-T operation to the lower lid and who had suffered from epiphora were evaluated retrospectively. Surgical application was carried out in the cases whose punctum eversion was 3 mm or over. Those who had cicatricial and paralytic ectropion, dacryostenosis and ectropion relapse and the cases whose follow-up period was shorter than 6 months were excluded from the study. Lower lid laxity and the laxity of the medial and lateral canthal tendons were evaluated in all patients preoperatively. Surgical technique was accepted as successful in the patients who had no epiphora, and the space between the eyelid disappeared. Results: Twenty five of the patients were female and 34 male. The mean age was 67.3±13.4 years. The mean follow-up period was 10.8±3.9 months. A notch on the incision line in the eye lid contour was observed in 3 eyes. Horizontal shortening was reiterated in six eyes whose ectropion did not reform well and success was achieved as a result. The success rate was 92.7% in the patients to whom we performed modified Lazy-T operation. Conclusion: The modified Lazy-T technique we applied in the surgical treatment of medial senile ectropion is an effective method which has fewer complications.