From the Department of Plastic and Reconstructive Surgery, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan.
Ann Plast Surg. 2020 Jun;84(6):632-637. doi: 10.1097/SAP.0000000000002160.
To determine whether patients with congenital lower lid epiblepharon treated with a modified Hotz procedure combined with epicanthoplasty have a decreased recurrence rate.
Patients with epiblepharon of the lower eyelid corrected using a modified Hotz method between 2007 and 2017 were evaluated retrospectively by chart review to determine rates of complications and recurrence as well as whether the Hotz method was combined with epicanthoplasty. The recurrence rates for patients treated with the Hotz method alone or in combination with epicanthoplasty were compared.
A total of 60 patients (mean age, 13.6 years) and 115 eyelids were evaluated. All patients showed improvement in their symptoms and had no complications. Across the entire group, the recurrence rate for entropion was 23.5% (27 eyes). A modified Hotz procedure combined with epicanthoplasty was performed on 43 (37.4%) eyes. The recurrence rate for the group treated with a modified Hotz procedure combined with epicanthoplasty was significantly lower than that for patients who underwent the Hotz procedure alone (7.0% vs 33.3% P = 0.0012). There was no relationship between epicanthus severity and recurrence rate (P = 0.345).
In this study, we showed that patients who underwent a modified Hotz procedure combined with epicanthoplasty had a decreased recurrence rate. This improved outcome could be due to the simpler approach to the nasal side of the lower eyelid in epicanthoplasty, and epicanthoplasty can facilitate detachment of the upper eyelid from the lower eyelid.
确定接受改良 Hotz 手术联合内眦赘皮矫正术治疗的先天性下睑皮赘患者的复发率是否降低。
通过病历回顾，对 2007 年至 2017 年间采用改良 Hotz 法治疗的下睑皮赘患者进行回顾性评估，以确定并发症和复发率，以及 Hotz 法是否与内眦赘皮矫正术联合使用。比较单独采用 Hotz 法和联合采用 Hotz 法和内眦赘皮矫正术治疗的患者的复发率。
共评估了 60 例患者（平均年龄 13.6 岁）和 115 只眼。所有患者的症状均有改善，且无并发症。在整个组中，内翻的复发率为 23.5%（27 只眼）。43 只眼（37.4%）行改良 Hotz 术联合内眦赘皮矫正术。改良 Hotz 术联合内眦赘皮矫正术组的复发率明显低于单独行 Hotz 术组（7.0%比 33.3%，P=0.0012）。内眦赘皮严重程度与复发率无相关性（P=0.345）。
本研究表明，接受改良 Hotz 术联合内眦赘皮矫正术的患者复发率降低。这种改善的结果可能是由于内眦赘皮矫正术中对下睑鼻侧的处理方法更简单，并且内眦赘皮矫正术可以促进上睑与下睑的分离。
