The surgical management of 95 cases of involutional entropion were reviewed to form this retrospective study. The 66 cases treated with the Wies procedure alone had a recurrence rate of 11%. The 29 cases treated with a combined procedure consisting of a Wies procedure with a lateral canthal horizontal shortening had no recurrences. All patients had a minimum of 6 months postoperative follow-up. The etiologic factors as they relate to the appropriate surgical procedures are discussed.