Lower eyelid tension balance reconstruction: A new procedure for the repair of congenital epiblepharon with epicanthus

Chen, Ben; Liu, Jia; Jian-xin, NI; Zhou, Shengjie; Chen, Xi

doi:10.1016/j.bjps.2018.12.002

Cited by 12 publications

(7 citation statements)

References 16 publications

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“…Following inner corner tightening, the previously parallel double eyelid may become tapered or fan-shaped. In other words, the eye shape prior to epicanthoplasty may give the impression of being elongated and sharp, but after the procedure, the eyes may appear rounder and the length of the palpebral ssure may shorten [12,13,14,15] . After epicanthoplasty, the skin tension in the corner of the eye is already taut, so in the earlier stages after the procedure, there may be more prominent scarring.…”

Section: Resultsmentioning

confidence: 99%

The Application of Reverse Z-Plasty Design in Medial Canthal Skin Redundancy Reconstruction Surgery.

Huahui,

Xiaohui,

Jiange

et al. 2023

Preprint

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Purpose To investigate the clinical outcomes of reverse Z-plasty in the reconstruction of epicanthal fold. Methods A retrospective analysis was conducted on the clinical data of patients who underwent reverse Z-plasty for epicanthal fold reconstruction from September 2019 to January 2023. The surgical procedure involved preoperative design line incision, dissection beneath the orbicularis oculi muscle to form a muscular flap, and using the temporal side muscular flap as the reconstructed epicanthal fold. Postoperative follow-up included assessing the degree of epicanthal fold reduction, the appearance of the epicanthal fold, incision scars, and patient satisfaction. The intercanthal distance was measured in all patients before surgery and at 6 months postoperatively, and the paired t-test was used for statistical analysis with a significance level of P < 0.05 indicating statistical significance. Results A total of 16 patients (15 females, 1 male) with an average age of 32 years (range: 17–38 years) were included in the study. All patients had a follow-up period of at least 3 months, with an average follow-up of 7 months. Patient satisfaction evaluation showed that 13 patients were very satisfied, 3 patients were satisfied, and there were no cases of dissatisfaction. The degree of exposure of the lacrimal prominence decreased in all patients, the shape of the epicanthal fold was natural, the size of bilateral eyelid fissure was appropriate, and the parallel double eyelids were transformed into fan-shaped double eyelids. The appearance of the incision scars was not prominent and the lines were smooth. The increase in intercanthal distance ranged from 3 to 6mm, with a range of ICD elongation ratio from 9.09–28.30%. The preoperative measurement of intercanthal distance ranged from 28 to 35.0mm, with a mean of 31.25 ± 2.32mm, and the postoperative measurement was 35.19 ± 2.26mm. The difference was statistically significant (t=-4.793, P < 0.001). There were no urgent or discomfort sensations in eye movement, and the results were satisfactory. Conclusion Reverse Z-plasty design is suitable for epicanthal fold reconstruction. The incision design is clear and precise, and the postoperative outcomes are stable, achieving successful reconstruction of the epicanthal fold.

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Section: Resultsmentioning

confidence: 99%

The Application of Reverse Z-Plasty Design in Medial Canthal Skin Redundancy Reconstruction Surgery.

Huahui,

Xiaohui,

Jiange

et al. 2023

Preprint

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“…Chen et al reported that the cilial entropion of epiblepharon patients is related to the tension imbalance in OOM. In their study, the key point of epiblepharon repair is to release the tension of OOM, which rides over the eyelid margin [ 16 ]. In addition, Lee and Denise reported that the levator and frontalis muscles act as antagonists on OOM [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Morphological changes after lower eyelid epiblepharon surgery in Asian children

Lee

et al. 2021

BMC Ophthalmol

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Background This study aimed to determine the morphological changes in Asian lower eyelid epiblepharon patients after surgery. Methods The medical records of 59 patients who underwent lower eyelid epiblepharon repair were reviewed retrospectively. Eighty-nine patients who underwent strabismus surgery were set as the control group. The photographs for each group were analyzed based on the following factors: inferior half area (IHA) of the eye, eyelash angular direction (EAD), angle between the eyelashes and the cornea, marginal reflex distance 1 (MRD1) and marginal reflex distance 2 (MRD2). Results After surgery, the medial EAD changed from 92.45° ± 20.21° (mean ± SD) to 79.43° ± 23.31°, while the central and lateral EADs were unchanged. IHA increased from 36.33 ± 9.78 mm3 to 43.06 ± 10.57 mm3, and MRD1 increased from 1.92 ± 0.99 mm to 2.50 ± 0.93 mm, whereas MRD2 did not change. The mean angle between the eyelashes and the cornea increased from 39.64° to 72.19° immediately postoperatively, but had reduced to 58.75° 3 months later, followed by no further significant change at the 6-month and 9-month postoperative follow-ups. Conclusions There is morphological changes of the eyelid after lower eyelid epiblepharon surgery, with increases in the IHA and MRD1. In addition, contact between the eyelashes and the cornea occurred mainly in the medial portion of the eyelid the position, which everted and stabilized over 3 months. Thus, follow-up observations are required for at least 3 months to properly evaluate the surgical outcome.

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“…[ 4 ] If untreated, entropion may result in severe ocular symptoms, including corneal thinning, vascularization, keratitis, and scarring. [ 1 , 2 , 5 , 6 ]…”

Section: Introductionmentioning

confidence: 99%

Outcomes of combined procedures compared to various single techniques for involutional entropion

Al-Mujaini,

Ul Kadir,

Maurya

2023

Oman Journal of Ophthalmology

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BACKGROUND: To describe the outcomes of triangular tarsectomy and limited orbicularis myectomy with lower eyelid retractor plication compared to an everting sutures (ES) technique or lateral tarsal strip (LTS) procedure for the correction of lower eyelid involutional entropion. METHODS: A nonrandomized clinical study was carried out at two tertiary eye hospitals between January 2016 and December 2019. Patients in Group A underwent triangular tarsectomy and limited orbicularis myectomy with lower eyelid retractor plication. Group B had ES, and Group C underwent a LTS procedure. All participants were operated by one surgeon and underwent 1-year follow-up. RESULTS: A total of 78 patients in whom 84 eyelids were affected by lower eyelid involutional entropion were included in the study. The success rate was higher in Group A compared to Group B and Group C (100% vs. 86.7% vs. 95.8%; P < 0.05). Recurrence at a 1-year follow-up was noted in only four (13.3%) eyelids in Group B and one (4.2%) in Group C. However, patient's in Group C experienced a higher frequency of minimal postoperative complications, including short-term pain (100%), tenderness on the lateral canthal area (100%), tightness of the eyelid (91.7%), and ecchymosis (54.2%) compared to Group A. Patients of Group B experienced minimal or no postoperative complications. CONCLUSIONS: Triangular tarsectomy and limited orbicularis myectomy with eyelid retractor plication may be considered the standard procedure for correcting lower eyelid involutional entropion with no recurrence compared to LTS technique or minimally invasive and cost-effective ES procedure.

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Lower eyelid tension balance reconstruction: A new procedure for the repair of congenital epiblepharon with epicanthus

Cited by 12 publications

References 16 publications

The Application of Reverse Z-Plasty Design in Medial Canthal Skin Redundancy Reconstruction Surgery.

The Application of Reverse Z-Plasty Design in Medial Canthal Skin Redundancy Reconstruction Surgery.

Morphological changes after lower eyelid epiblepharon surgery in Asian children

Outcomes of combined procedures compared to various single techniques for involutional entropion

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