Combined wedge resection and inferior retractor plication versus combined lateral tarsal strip and inferior retractor plication in involutional entropion

Abstract

Purpose: To compare the effectiveness of combined wedge resection and inferior retractor plication (WR+IRP) based on the Hill’s procedure with combined lateral tarsal strip with inferior retractor plication procedure (LTS + IRP) for the treatment of primary involutional lower eyelid entropion in the Chinese population. Methods: This is a retrospective review of 52 eyelids of 46 patients who underwent WR+IRP and 41 eyelids of 36 patients that underwent LTS + IRP for treatment of involutional entropion between May 2009 and May 2017. Patient demographics, presence of pre-operative laxity, post-operative outcome and presence of complications were all recorded from electronic patient records. Results: Among patients who received combined WR + IRP, none had recurrence of entropion, 1 (2.1%) had residual entropion, 2 eyelids (4.35%) had lower eyelid notching, 1 eyelid (2.17%) had infection and 1 eyelid (2.17%) had overcorrection. In the group of patients with LTS + IRP, 9 eyelids (21.95%) had recurrence and 1 (2.44%) had residual entropion. Patients with LTS + IRP had statistically significantly higher recurrence rate than WR + IRP (p<0.001). The overall success rate was higher in the combined WR + IRP group than the LTS + IRP group (88.24% vs 78.05%), however, it did not reach statistical significance (p=0.189). Conclusion: Both LTS + IRP and WR + IRP are effective surgical procedures for involutional entropion. LTS + IRP has significantly higher recurrence rate. Although the overall success rate is higher in combined WR + IRP, it did not reach statistical significance.