AIM: To compare the efficacy of two surgical approaches that microscopical Hotz combined with eyelid margin incision and flap translocation and pure Hotz method in correction of severe upper eyelid cicatricial entropion.

METHODS: Totally 84 eyes of 60 patients who underwent corrective surgery for upper eyelid trichiasis between July 2017 to July 2019 were retrospectively assessed. The patients in trial group(32 cases, 42 eyes)underwent the surgical procedure of combining Hotz with eyelid margin incision and skin flap transposition under microscope, the other group(28 cases, 42 eyes)were treated with Hotz method. The follow-up time was 12mo. Subjective symptoms, eyelid marginal position, eyelash eversion and patient satisfaction were recorded.

RESULTS: The surgery time of one eye in trial group was longer than that in control group(40.8±2.57min vs 28.5±2.64min, P<0.01). The cure rates of 1 and 12mo in trial group were 100% and 95%, respectively. And those in control group were 95% and 76%, respectively. The cure rate of 12mo in trial group was higher than that of the control group(P=0.013). There was no significant difference in patient satisfaction between the two groups at 1mo after surgery(Z=1.1825, P=0.2371). 12mo after surgery, patient satisfaction in the trial group was higher than that in the control group(Z=3.7346, P<0.01).

CONCLUSION: While it spents longer time, the procedure of combining Hotz with eyelid margin incision and skin flap transposition under microscope is reasonably successful and satisfactory in rectifying severe upper eyelid cicatricial entropion. It offers more higher cure rate than Hotz alone at long time after operation.