The Efficacy of the Combined Procedure in Involutional Entropion Surgery: A Comparative Study

Involutional entropion leads to corneal epithelial problems, ocular irritation, and blepharospasm in an elderly population. Without treatment, entropion can cause corneal ulceration, microbial keratitis, visual loss, or even eye loss. Various factors contribute to the inward rotation of the eyelid margin, including thinning of the tarsal plate, atrophy of orbital fat tissue, horizontal lid laxity, vertical lid laxity secondary to dehiscence, disinsertion or laxity of lower lid retractors, and overriding of the preseptal orbicularis onto the pretarsal orbicularis secondary to the loosening of adhesion of the orbicularis and skin to the tarsal plate [1-3]. Many surgical procedures have been described for the management of entropion, and varying success rates have been reported, even for the same surgical techniques performed by different authors [4-14]. Because of the multifactorial nature of the disease, no entirely satisfactory surgical technique has yet been reported [4]. Due to a lack of comparative studies, the best surgical technique remains controversial. We performed the combined procedure, comprised of a lateral tarsal strip (LTS), retractor tightening, and everting sutures (ES), on 45 eyes with involutional entropion and compared the results with those of 31 eyes which had undergone the Wies procedure.