Abstract:For patients with medial lower lid epiblepharon with epicanthal fold without excessive skin and muscle, a simple skin-redraping medial epicanthoplasty without traditional epiblepharon correction methods showed good results of epiblepharon repair.
“…In conclusion, among the classifications of the previously reported procedures, the current procedure could be considered both a “skin flap” and a “redraping” method, because the feature of our current procedure has both aspects of a skin flap that rotates 18,19 and a redraping method that repositions the skin of the eyelids 20–22 . Based on the significance of the previously reported methods, our current procedure is an easy, safe, and effective surgical method that can be used for all types of epiblepharon with an epicanthal fold to achieve a successful functional and cosmetic outcome.…”
This report aimed to introduce the new adjustable rotational skin flap for epicanthoplasty in combination with traditional epiblepharon repair by the modified Hotz procedure. This retrospective study involved 25 consecutive patients with superficial punctate keratitis secondary to epiblepharon complicated with epicanthal fold who underwent the combined surgery between 2019 and 2020. The mean patient age was 11.4 years in this study with a median follow-up was 8months (range, 3-12months). The rationale of the surgery was to release vertical tension of the eyelids by dissecting dense connective tissue beneath the epicanthal fold and to form a new medial canthus using a rotational skin flap supplied by the redundant the upper and/or lower eyelid skin excised during the epiblepharon repair. Postsurgical resolution ofsuperficial punctate keratitis and patient satisfaction was achieved in all patients. Additionally, there were no complications, and no revisional surgery was required in all patients for a median 8 months follow-up period. Utilizing a rotational skin flap during epiblepharon repair is a useful adjunct during epicanthoplasty surgery. This modification is well tolerated and allows for intraoperative adjustment, whereas minimizing scarring and allowing for improved tissue relaxation.
“…In conclusion, among the classifications of the previously reported procedures, the current procedure could be considered both a “skin flap” and a “redraping” method, because the feature of our current procedure has both aspects of a skin flap that rotates 18,19 and a redraping method that repositions the skin of the eyelids 20–22 . Based on the significance of the previously reported methods, our current procedure is an easy, safe, and effective surgical method that can be used for all types of epiblepharon with an epicanthal fold to achieve a successful functional and cosmetic outcome.…”
This report aimed to introduce the new adjustable rotational skin flap for epicanthoplasty in combination with traditional epiblepharon repair by the modified Hotz procedure. This retrospective study involved 25 consecutive patients with superficial punctate keratitis secondary to epiblepharon complicated with epicanthal fold who underwent the combined surgery between 2019 and 2020. The mean patient age was 11.4 years in this study with a median follow-up was 8months (range, 3-12months). The rationale of the surgery was to release vertical tension of the eyelids by dissecting dense connective tissue beneath the epicanthal fold and to form a new medial canthus using a rotational skin flap supplied by the redundant the upper and/or lower eyelid skin excised during the epiblepharon repair. Postsurgical resolution ofsuperficial punctate keratitis and patient satisfaction was achieved in all patients. Additionally, there were no complications, and no revisional surgery was required in all patients for a median 8 months follow-up period. Utilizing a rotational skin flap during epiblepharon repair is a useful adjunct during epicanthoplasty surgery. This modification is well tolerated and allows for intraoperative adjustment, whereas minimizing scarring and allowing for improved tissue relaxation.
“… Side-view angle (SVA), corresponding to the average of the maximum and minimum angles between the eyelashes and a tangential line to the cornea (Fig. 2 d) [ 6 ]. Fig.…”
Section: Methodsmentioning
confidence: 99%
“…Several previous studies have analyzed the surgical outcome depending on the shape of the eyelid before surgery in epiblepharon patients. For example, Oh et al reported on eyelashes changes from a lateral perspective [ 6 ]. They interpreted the postoperative improvement based on the angle between the eyelashes and the cornea, and found that successful surgical results were associated with larger angles.…”
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.
“…Their work demonstrated a decrease in the inner intercanthal distance ratio after the operation and an excellent cosmetic outcome. Oh et al [29] recently reported utilizing the redraping epicanthoplasty technique in medial lower epiblepharon in 12 Korean children. Many oculoplastic surgeons prefer this technique as it is simple and reliable for both cosmetic and reconstructive purposes.…”
For optimal surgical results in Asian upper eyelid surgery, presence of the epicanthal fold and surgical correction options should be discussed primarily.
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