改良Z形内眦开大术联合重睑成形术矫正内眦赘皮

A modified Z epicanthoplasty combined with double eyelid plasty for correction of medial epicanthus

目的 探索改良Z形内眦开大术联合重睑成形术矫正内眦赘皮的效果.方法 在内眦部应用改良Z成形术, 将内眦赘皮与下睑交界的内侧及外侧皮肤对应切开后,修剪错位的眼轮匝肌并缩短内眦韧带,沿新内眦点向内侧切开,将内眦赘皮水平移位,松解内侧睑缘处皮肤张力,显露内眦.在上睑中外侧行重睑切开线,保留与内眦开大术切口之间的部分皮肤.结果 自2008年2月至2010年12月,临床治疗21例（42只眼）上睑型内眦赘皮求美者.术后随访3～14个月,赘皮消失, 内眦完全敞开, 内眦处无明显瘢痕,重睑线流畅,效果满意.结论 本方法易于掌握,可有效松解上睑内侧皮肤张力,充分显露内眦形态,瘢痕不明显.

Objective To explore the clinical effect on correction of medial epicanthus with a modified Z epieanthoplasty combined with double eyelid plasty. Methods The medial canthoplasty was performed first with a modified Z-plasty. Incisions were made along the juncture of medial canthal fold with the lower eyelid to the medial-most point of lacrimal lake. Dissection of orbieularis oculi muscle was made and medial eanthal tendon was shortened by mattress sutures. A horizontal incision was made medially from medial-most point of lacrimal lake to form a recipient for medial canthal fold. The double eyelid plasty incision was made by leaving a few millimeters intact skin from incision of the modified Z eanthoplasty. Results Totally 21 cases with mild or moderate medial epicanthus without upper eyelid fold were treated with the methods mentioned above, from February- 2008 to December 2010. A 3 to 14 months follow-up study showed that the epicanthus was corrected completely or mostly and the upper eyelid fold was the parallel type with slight scar around the medial canthus. Satisfactory resuhs were received for the nice appearance. Conclusion This surgical technique is easy to perform, It could release the skin lension of medial eanthal fold sufficiently and expose the natural medial canthus without obvious scar.