Oyama Tokuhide, Oyama Mari, Tazawa Ayako, Fukuchi Takeo
From the Department of Oculoplastic Surgery, Uonuma Eye Clinic, Uonuma city, Niigata, Japan.
Department of Ophthalmology, Nagaoka Red Cross Hospital, Nagaoka city, Niigata, Japan.
Plast Reconstr Surg Glob Open. 2025 Apr 18;13(4):e6678. doi: 10.1097/GOX.0000000000006678. eCollection 2025 Apr.
Epiblepharon is a congenital anatopism characterized by a horizontal skinfold near the eyelid margin, causing corneal irritation and damage. Standard surgical management occasionally results in undercorrection and relatively high recurrence. In addition, a pronounced postoperative lower eyelid crease can be an unfavorable cosmetic alteration, particularly for Asian patients. This work describes a new surgical technique to reduce recurrence rates while improving cosmetic and functional outcomes for epiblepharon.
Thirty-nine patients (75 eyelids) underwent epiblepharon surgery from January 2021 to April 2023. Their mean age was 15.0 years with a mean follow-up period of 16.5 months. Surgically, the lower eyelid retractors (LERs) were fully exposed and detached from the inferior tarsus margin and conjunctiva. The free LERs were sutured directly to the marginal orbicularis oculi muscle, maintaining flexible mobility to the LERs without standard anchoring to the tarsus margin.
All 39 patients achieved complete eversion of the cilia without cornea contact by the final follow-up. Of the 75 eyelids, 70 (93%) demonstrated a "good" outcome, 5 (7%) had a "fair" outcome, and none were classified as "poor." Mean margin-to-reflex distance 2 remained statistically unchanged between preoperative and postoperative measurements.
Our new surgical method provides satisfactory functional and cosmetic results, reducing recurrence rates and minimizing the risk of excessive lower eyelid crease, ectropion, and severe hypertrophic scarring. The method offers a reliable alternative, particularly for Asian patients, who typically have less pronounced eyelid creases.
睑缘内翻是一种先天性解剖异常，其特征为睑缘附近有一水平皮肤皱襞，可导致角膜刺激和损伤。标准手术治疗偶尔会导致矫正不足和相对较高的复发率。此外，明显的术后下睑皱襞可能是一种不良的美容改变，尤其是对亚洲患者而言。本文描述了一种新的手术技术，可降低复发率，同时改善睑缘内翻的美容和功能效果。
2021年1月至2023年4月，39例患者（75只眼）接受了睑缘内翻手术。他们的平均年龄为15.0岁，平均随访期为16.5个月。手术中，充分暴露下睑缩肌（LERs），并将其从睑板下缘和结膜分离。游离的LERs直接缝合至眼轮匝肌边缘，使LERs保持灵活的活动度，而无需标准地固定于睑板边缘。
在最后一次随访时，所有39例患者的睫毛均完全外翻，未接触角膜。在75只眼中，70只（93%）显示“良好”结果，5只（7%）为“一般”结果，无一只被归类为“差”。术前和术后测量的平均边缘至反射距离2在统计学上保持不变。
我们的新手术方法提供了令人满意的功能和美容效果，降低了复发率，并将下睑皱襞过度、睑外翻和严重增生性瘢痕形成的风险降至最低。该方法提供了一种可靠的替代方案，尤其适用于通常睑皱襞不太明显的亚洲患者。
