Department of Plastic Surgery, Fujisawa Shounandai Hospital, 2345 Takakura, Fujisawa-shi, Kanagawa 251-0802, Japan; Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, 4-57 Urafune, Minami-ku, Yokohama-shi, Kanagawa 232-0024, Japan.
Department of Ocular Plastic & Orbital Surgery, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu-shi, Shizuoka 430-8558, Japan.
J Plast Reconstr Aesthet Surg. 2024 Jan;88:224-230. doi: 10.1016/j.bjps.2023.11.001. Epub 2023 Nov 4.
Epiblepharon is an eyelid disease affecting 46-52.5% of Asian children. The Hotz procedure was commonly used for the treatment. However, the currently preferred technique is the rotating suture technique. This study aimed to report the recurrence rate and the complications of using the rotating suture technique combined with lid margin split and lower eyelid retractor (LER) disinsertion of epiblepharon. This was a retrospective study of the procedures performed between January 2017 and December 2020. This study included 64 eyelids of 37 patients who underwent the consecutive rotating suture technique, lid margin split, and LER disinsertion simultaneously for lower eyelid epiblepharon and were followed up for at least 6 months. The mean age of the patients who underwent surgery was 9.5 (5-28) years. The mean observation period was 8.3 (6-27) months. Recurrence was observed in one eyelid (1.6%). The complications included an ectopic eyelash on one eyelid (1.6%). LER disinsertion performed in this study had two advantages. First, the imbalance between the anterior and posterior lamellae was corrected. Disinserting the LER, the tarsal plate could be repositioned cranially, effectively addressing this imbalance. Second, LER disinsertion ensured direct exposure of the lower margin of the tarsal plate, facilitating the implementation of a reliable rotating suture. In conclusion, promising results were achieved by combining the rotating suture technique with LER disinsertion and lid margin splitting.
内眦赘皮是一种影响 46-52.5%亚洲儿童的眼睑疾病。Hotz 手术通常用于治疗该疾病。然而，目前首选的技术是旋转缝线技术。本研究旨在报告采用旋转缝线技术联合睑缘切开和下眼睑牵引器（LER）离断治疗内眦赘皮的复发率和并发症。这是一项回顾性研究，对 2017 年 1 月至 2020 年 12 月期间连续采用旋转缝线技术、睑缘切开和 LER 离断治疗下眼睑内眦赘皮的 37 例患者的 64 只眼睑进行了研究，所有患者的随访时间至少为 6 个月。手术患者的平均年龄为 9.5 岁（5-28 岁）。平均观察期为 8.3 个月（6-27 个月）。1 只眼睑（1.6%）出现复发。并发症包括 1 只眼睑的睫毛异位（1.6%）。本研究中 LER 离断有两个优点。首先，纠正了前后板层之间的不平衡。离断 LER 后，可将睑板朝颅侧重新定位，有效解决这种不平衡。其次，LER 离断可确保睑板下边缘直接暴露，便于实施可靠的旋转缝线。总之，联合使用旋转缝线技术、LER 离断和睑缘切开术取得了良好的效果。
