Outcome of Weis Procedure Versus Combined Procedure in Involutional Entropion of Lower Eyelid

Karki P*, Sharma B*


INTRODUCTION: Involutional entropion of the lower eyelid is a common problem in the ageing population. Surgery must correct horizontal laxity, vertical laxity and overriding of the tarsus by the intratarsal issues. The purpose of this study is to evaluate the efficacy of the combined procedure over the Weis procedure in the management of involutional entropion in terms of anatomical success, recurrence rate and cosmetic appearance.

METHOD: In this retrospective comparative study, we reviewed 76 eyelids of 61 consecutive patients of involutional entropion from March 2013 to September 2014. Out of which 45 eyelids of 35 patients underwent combined procedure (retractor plication and lateral tarsal strip) and 31 eyelids of 25 patients underwent Weis procedure. Exclusion criteria included the patents who had undergone previous lower eyelid surgery and who followed up for less than 6 months.

RESULT: Entropion was not seen in first postoperative day in both the groups. The mean follow–up period was 12 months. During the follow-up period, 9 of 31 (29%) eyes which had undergone the Weis procedure presented with recurrence, whereas 1 of35 (3.5%) eyes treated with combined procedure presented with recurrence (p=0.001). The average time of recurrence in the Weis group was 4.8 months and 2 months in combined group. Three patients complained about a visible incision line after the Weis procedure. Age of the patents and duration of the symptoms
was not significant.

CONCLUSION: The combined procedure is more effective than the Weis procedure in terms of anatomical outcome and less recurrence 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 with more cosmetically acceptable result. Duration and cost of surgery in both the groups was not significant.

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