个性化手术治疗下睑赘皮性倒睫的有效性和安全性

Customized surgery in treatment of lower eyelid epiblepharon correction

目的评估个性化手术治疗下睑赘皮性倒睫的有效性和安全性。方法回顾性分析2018-07-01至2020-06-30门诊接受下睑赘皮手术的患者49例90眼。术前评估内眦赘皮对下睑睫毛的影响,确定是否同时进行内眦赘皮矫正术,下睑赘皮矫正和内眦赘皮矫正分别采用改良Hotz法和皮肤重置法。手术成功定义为术后睫毛与角膜夹角超过45°。结果49例90眼中,32眼(35.6%)因存在的内眦赘皮对下睑睫毛方向有垂直牵拉作用而同时进行了下睑和内眦手术。5例(10.2%)患者进行了下睑、内眦和上睑的同期手术,均为双眼患者。睫毛与角膜夹角超过45°者82眼(91.1%),睫毛与角膜夹角小于45°但无接触者8眼(8.9%)。皮肤瘢痕程度可接受。结论术前评估内眦赘皮对下睑睫毛的垂直牵拉作用、选择正确术式是治疗成功的前提和关键。

Objective To evaluate the results of customized surgery in treating lower eyelid epiblepharon correction.Methods Forty-nine patients(ninety eyes)with lower eyelid epiblepharon who underwent surgery from July 2018 to June 2020 were retrospectively analyzed.Before operation,the vertical traction of epicanthus on lower eyelid eyelashes was evaluated,according to which the combined epicanthoplasty was performed or not.Hotz procedure and skin redraping procedure were respectively used to with to correct lower eyelid epiblepharon and epicanthus.Results Due to the obvious traction of epicanthus on lower eyelid eyelashes,thirty-two patients(35.6%)received simultaneous surgery for lower eyelid and epicanthus.The postoperative angles of eighty-two eyes(91.1%)were more than 45°between the eyelashes and the cornea,while those of eight eyes(8.9%)were less than 45°but with no contact between the eyelashes and the cornea.In all patients trichiasis-related symptoms disappeared,and skin scarring was acceptable and there was no aesthetic dissatisfaction.Conclusions Preoperative evaluation of the vertical traction of epicanthus on lower eyelid eyelashes and reasonable surgical procedure are the premise and key to the success of the surgery.