Objective To explore the clinical effect of individualized surgical treatment in the treatment of senile lower eyelid entropion and trichiasis. Methods A total of 78 patients with senile lower eyelid entropion and trichiasis admitted to Chengde County Hospital from November 2021 to November 2022 were selected as the research objects. They were divided into control group and observation group by random number table method, with 39 patients in each group. The control group was treated with simple eyelid skin orbicularis oculi muscle resection and suture, and the observation group was treated with individualized surgical treatment. The clinical efficacy and surgical satisfaction of the two groups were compared. Results The total effective rate of treatment in the observation group was 94.87%, which was higher than 74.36% in the control group (P <0.05). The satisfaction scores of appearance, scar appearance, binocular symmetry, trichiasis correction and comfort in the observation group were higher than those in the control group (P <0.05). Conclusion The clinical effect of individualized surgical treatment of senile lower eyelid entropion and trichiasis is good, which can effectively improve the clinical symptoms of patients, and the patients ' satisfaction with the operation is high.It is worthy of clinical application.