Kashima Tomoyuki, Katori Nobutada, Yamada Takayuki, Imagawa Yukihiro, Nakauchi Kazuaki
Department of Ophthalmology, Gunma University School of Medicine, Maebashi-shi, Japan.
Nippon Ganka Gakkai Zasshi. 2010 Feb;114(2):105-9.
Postoperative recurrence is common following surgery in patients with epiblepharon and co-existing epicanthal folds. We report the results of using combined epicanthoplasty and modified Hotz's procedure techniques aimed at correcting the structural anomalies and improving surgical out-come.
We performed combined epicanthoplasty and modified Hotz's procedure procedures on 5 patients (10 eyelids) between May 2007 and October 2008. The surgical procedures involved redraping the medial canthal skin folds using Uchida's method in 4 patients and Z-plasty in 1 patient.
Epiblepharon was resolved following surgery, and the symptoms improved immediately. The preoperative pathognomonic appearance with the nasal conjunctiva almost hidden by the epicanthus changed, and the nasal conjunctiva became visible postoperatively. There were no signs of recurrence at postoperative follow up (range, 6-20 months, mean 9.4 months).
Combined epicanthoplasty and modified Hotz's procedure produced good postoperative results, with no signs of recurrence. However, lack of experience in skin flap design and inappropriate surgical manipulation could lead to unsightly scar formation and adverse cosmetic results. We therefore recommend that epicanthoplasty be decided by experts in oculoplastic surgery.
睑缘内翻合并内眦赘皮患者术后复发很常见。我们报告采用联合内眦成形术和改良霍茨手术技术纠正结构异常并改善手术效果的结果。
2007年5月至2008年10月，我们对5例患者（10只眼）实施了联合内眦成形术和改良霍茨手术。手术操作包括4例患者采用内田法重新塑形内眦部皮肤皱襞，1例患者采用Z成形术。
术后睑缘内翻得到解决，症状立即改善。术前特征性外观，即鼻侧结膜几乎被内眦赘皮遮盖的情况发生改变，术后鼻侧结膜可见。术后随访（范围6 - 20个月，平均9.4个月）无复发迹象。
联合内眦成形术和改良霍茨手术术后效果良好，无复发迹象。然而，皮瓣设计经验不足和手术操作不当可能导致难看的瘢痕形成和不良美容效果。因此，我们建议内眦成形术由眼整形手术专家决定。
