A comparative study of two procedures for repair of involutional lower lid entropion

Abstract

Objective The study compares the use of Jones’ retractor plication and the Wies procedure as a primary procedure for the repair of involutional lower lid entropion in the absence of horizontal lid shortening. Design Retrospective case series comparison. Participants One hundred two cases with at least 6 months follow-up after primary surgery for involutional lower lid entropion performed between 1993 and 1996. Interventions Two groups were compared: Jones’ retractor plication was performed in one group and the Wies procedure in the other; neither group had horizontal shortening of the lower eyelid. Main outcome measures The rates of cure, recurrence, and overcorrection of the lower lid entropion. Results Jones’ retractor plication was performed in 37 (36%) patients and the Wies procedure in 65 (64%). Two of the 37 (5%) Jones cases had recurrent entropion develop, both at 31 months after surgery, compared with 11 of 65 (17%) recurrences after the Wies procedure ( P = 0.81); recurrence after Wies procedure was earlier, at a median of 6 months after surgery. There were 20 of 65 (31%) overcorrections after the Wies procedure and 4 of 37 (11%) after the Jones procedure ( P < 0.02); one quarter of each group required secondary repair of the overcorrection (5 of 20 after failed Wies procedure; 25% after failed Jones procedure). Overall, there were 6 of 37 (16%) unsatisfactory results after the Jones procedure in contrast to 31 of 65 (48%) after the Wies procedure ( P < 0.001). Conclusions These data provide strong evidence ( P < 0.001) that, in the absence of horizontal shortening of the lower eyelid, a successful outcome is more likely after Jones retractor plication than after the Wies procedure.