Long-Term Outcomes of the Wies/Quickert Procedure with Horizontal Eyelid Shortening Versus Lateral Tarsal Strip with Everting Sutures for Involutional Entropion: A Retrospective Study

Abstract

Background: Involutional entropion is a common eyelid malposition in elderly patients and is associated with horizontal and vertical eyelid laxity. Several surgical techniques are available; however, data directly comparing their long-term outcomes are limited.

Objective: To evaluate and compare long-term recurrence rates following the Wies/Quickert procedure with horizontal eyelid shortening and the Lateral Tarsal Strip (LTS) procedure combined with everting sutures.

Methods: A retrospective analysis was conducted of patients treated for involutional lower eyelid entropion between 2010 and 2021. Group 1 included eyes treated with the Wies/Quickert procedure combined with horizontal eyelid shortening. Group 2 included eyes treated with LTS and everting sutures. Both primary and revision cases were included. Follow-up was performed at 6, 12, and 36 months in both groups, with extended follow-up to 60 months in Group 1.

Results: A total of 169 eyes were included (102 in Group 1, 67 in Group 2). Group 1 demonstrated no recurrences at 6, 12, or 36 months. One late recurrence (0.98%) was observed beyond 60 months. Group 2 showed no recurrences at 6 months, one recurrence (1.49%) at 12 months, and one recurrence (1.49%) at 36 months, resulting in a total recurrence rate of 2.98%.

Conclusion: Both surgical techniques provide effective correction of involutional entropion with low recurrence rates. The Wies/Quickert procedure combined with horizontal eyelid shortening demonstrated excellent long-term anatomical stability, suggesting potential superiority in patients with combined horizontal and vertical eyelid laxity.