The Wies procedure for management of trichiasis or cicatricial entropion of either upper or lower eyelids

Abstract

Aim: To report the efficacy of the Wies procedure (transverse blepharotomy and marginal rotation) in the management of trichiasis or cicatricial entropion of the upper or lower eyelid.

Methods: A retrospective chart review was performed of all cases of Wies eyelid rotations supervised or performed by one surgeon for cicatricial entropion or trichiasis of the upper or lower eyelids over a 16-year period to assess the indications, success rate and complications of the procedure. Where follow-up was less than 6 months, telephone interviews were conducted to assess patient satisfaction with the surgery. Patients not meeting these criteria were excluded from the final analysis. Success was defined as no recurrence of the entropion or trichiasis and/or patient satisfaction at least 6 months postoperatively. Statistical analysis was performed using a χ² test.

Results: 126 eyelids (77 upper lids, 49 lower lids) were identified in 89 patients (53 single eyelid, 33 multiple eyelids) who underwent a Wies procedure with a minimum follow-up period of 6 months. The mean follow-up period was 67 months (range 6–188 months). The overall success rate was 85%. 13 eyelids (10%) developed complications. 18 eyelids (14%) developed recurrences that required a second procedure. 10 of these second procedures were repeat Wies procedures, one of which was followed by electrolysis. All of these second Wies procedures were successful.

Conclusions: The Wies procedure (transverse blepharotomy and marginal rotation) is reasonably successful in managing trichiasis and cicatricial entropion of either upper or lower eyelids.