Department of Plastic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Craniofac Surg. 2021 Sep 1;32(6):2198-2201. doi: 10.1097/SCS.0000000000007410.
Z-epicanthoplasty is a popular method of correcting mild to moderate epicanthal folds. However, it has some limitations, such as, under correction, recurrence, and leaving of a visible scar. This study aimed to modify the traditional Z-epicanthoplasty to optimize its application in correcting severe cases of epicanthal fold.
A total of 117 Asian female patients received the modified Z-epicanthoplasty between January 2018 and April 2018. The type and severity of epicanthal fold were evaluated preoperatively, whereas the intercanthal distance, interpupillary distance, and scar visibility and cosmetic results were evaluated preoperatively and one-year postsurgery.
A total of 142 eyes had epicanthus tarsalis, whereas 92 eyes had epicanthus palpebralis. Of these, 29 were mild, 95 were moderate, and 119 were severe. After the operation, the intercanthal distance ratio was decreased from 0.615 (range, 0.548-0.685) preoperatively to 0.564 (range, 0.500-0.632). The mean reduction was 5.1% (range, 1.2%-10.1%; P < 0.001, Wilcoxon signed-rank test). Also, 195 eyes (83.3%) had no apparent scar and 36 (15.4%) had visible scar only under close inspection. Three eyes (1.32%) had visible scar without the need for revision. No reoccurrence was observed. And the cosmetic outcomes were scored as either excellent or good.
The modified Z-epicanthoplasty which released the medial canthus activity sufficiently and corrected epicanthal fold at its maximum displacement is an effective method for the treatment of all degrees of epicanthus tarsalis and epicanthus palpebralis in Asian females.
Z 成形术是一种矫正轻度至中度内眦赘皮的常用方法。然而，它存在一些局限性，如矫正不足、复发和留下可见的疤痕。本研究旨在改良传统 Z 成形术，优化其在重度内眦赘皮矫正中的应用。
2018 年 1 月至 2018 年 4 月，共 117 例亚洲女性患者接受了改良 Z 成形术。术前评估内眦赘皮的类型和严重程度，评估术前和术后 1 年的内眦间距、瞳孔间距、瘢痕可见度和美容效果。
共 142 只眼有睑板内眦赘皮，92 只眼有睑缘内眦赘皮。其中轻度 29 只，中度 95 只，重度 119 只。手术后，内眦间距比从术前的 0.615（范围 0.548-0.685）降至 0.564（范围 0.500-0.632）。平均减少 5.1%（范围 1.2%-10.1%；P < 0.001，Wilcoxon 符号秩检验）。此外，195 只眼（83.3%）无明显瘢痕，36 只眼（15.4%）仅在近距离观察时可见瘢痕。3 只眼（1.32%）可见瘢痕，无需再次修复。无复发。美容效果评定为优或良。
改良 Z 成形术充分松解内眦活动度，最大限度矫正内眦赘皮，是治疗亚洲女性各种程度睑板内眦赘皮和睑缘内眦赘皮的有效方法。
