Ni Jianxin, Shao Congqin, Wang Kaiyuan, Chen Xi, Zhou Shengjie, Lin Hemin
Department of Ophthalmological Plastic Surgery, The Affiliated Eye Hospital of Wenzhou Medical University, Wenzhou, China.
Ophthalmic Plast Reconstr Surg. 2017 Mar/Apr;33(2):120-123. doi: 10.1097/IOP.0000000000000664.
To compare the outcomes of the modified Hotz procedure alone and combined with modified Z-epicanthoplasty for correction of epiblepharon.
Seventy-one Chinese patients who underwent epiblepharon repair were divided into 2 groups. In group 1, 33 patients (59 eyes) were operated on with the modified Hotz procedure. In group 2, 38 patients (71 eyes) were operated on with the modified Hotz procedure combined with modified Z-epicanthoplasty. Treatment outcomes were classified as "excellent" with no cilium-ocular surface touching, "fair" with 5 or fewer cilia-ocular surface touchings, and "poor" with more than 5 cilia-ocular surface touchings. Incision scars were evaluated by the Vancouver scar scale (VSS).
There were no significant differences in the age or sex distribution between the two groups. For group 1, the outcome was excellent for 46 eyes (78%) and fair or poor for 13 eyes (22%). For group 2, the outcome was excellent for 70 eyes (98.6%) and fair for only 1 eye (1.4%). Thus, group 2 had significantly more excellent outcomes compared with group 1 (p < 0.001). The Vancouver scar scale of the lower eyelids in group 1 was 1.10 ± 0.30 and 1.04 ± 0.20 in group 2 after correcting for the follow-up period (p = 0.292). The medial canthus Vancouver scar scale in group 2 was 1.13 ± 0.37, which was not different from the lower eyelid Vancouver scar scale (p = 0.471).
The modified Hotz procedure combined with modified Z-epicanthoplasty is more effective in correcting lower eyelid epiblepharon than the modified Hotz procedure alone. The combined procedure does not produce obvious lower eyelid or medial canthus scars.
比较单纯改良Hotz手术及联合改良Z形内眦成形术矫正睑内翻的效果。
71例行睑内翻修复术的中国患者被分为两组。第1组，33例患者（59只眼）接受改良Hotz手术。第2组，38例患者（71只眼）接受改良Hotz手术联合改良Z形内眦成形术。治疗效果分为“优”（睫毛与眼表无接触）、“良”（睫毛与眼表接触5次及以下）和“差”（睫毛与眼表接触超过5次）。采用温哥华瘢痕量表（VSS）评估切口瘢痕。
两组患者的年龄和性别分布无显著差异。第1组，46只眼（78%）效果为优，13只眼（22%）效果为良或差。第2组，70只眼（98.6%）效果为优，仅1只眼（1.4%）效果为良。因此，与第1组相比，第2组的优效结果显著更多（p < 0.001）。校正随访期后，第1组下睑的温哥华瘢痕量表评分为1.10±0.30，第2组为1.04±0.20（p = 0.292）。第2组内眦部温哥华瘢痕量表评分为1.13±0.37，与下睑温哥华瘢痕量表评分无差异（p = 0.471）。
改良Hotz手术联合改良Z形内眦成形术矫正下睑睑内翻比单纯改良Hotz手术更有效。联合手术不会产生明显的下睑或内眦部瘢痕。
