title: The efficacy of the combined procedure in involutional entropion surgery: a comparative study.
abstract: OBJECTIVE
  To evaluate the efficacy of the combined procedure in the management of involutional entropion.
  
  
  METHODS
  In this study, we reviewed 45 eyes of 36 patients who underwent the combined procedure (lateral tarsal strip, retractor tightening, and everting sutures) for the management of involutional lower eyelid entropion and compared the results with 31 eyes of 25 patients who underwent the Wies procedure. Exclusion criteria included previous lower eyelid surgery and follow-up of less than 6 months.
  
  
  RESULTS
  No patients demonstrated entropion on the first postoperative day. The mean follow-up period was 18.4 months (6 to 52 months) in the Wies group and 22.6 months (6 to 59 months) in the combined procedure group. During the follow-up period, 9 of 31 eyes in the Wies group presented with recurrence and only 1 of 45 eyes in the combined procedure group presented with recurrence (p = 0.001). The average time of recurrence was 4.8 months in the Wies group. Recurrence occurred at 2 months postoperatively in the patient in the combined procedure group. Six of the 9 recurrences in the Wies group were managed by the combined procedure. None of these patients had further recurrence after correction. Three patients complained about a visible incision line after the Wies procedure.
  
  
  CONCLUSIONS
  The combined procedure seems to be more effective than the Wies procedure in the management of involutional entropion. The combined procedure addresses the three major causative factors in involutional entropion and makes it possible to perform the surgery using a small incision.
authors: Eye Clinic, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey.
authors: Didem
authors: D
authors: Serin
authors: Ibrahim Bulent
authors: IB
authors: Buttanri
authors: Safak
authors: S
authors: Karslioglu
authors: Mehmet Sahin
authors: MS
authors: Sevim
authors: Bahtinur
authors: B
authors: Buttanri
authors: Muslime
authors: M
authors: Akbaba
mesh_terms: D000328:Adult; D000368:Aged; D019882:Blepharoplasty / Q000379:methods*; D004774:Entropion / Q000601:surgery*; D005143:Eyelids / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D016896:Treatment Outcome
keywords: Combined procedure; Entropion; Wies