改良微创横切纵缝内眦赘皮矫正在同期三点重睑成形术中的应用

Application of modified minimally-invasive transverse-vertical epicanthoplasty in double-eyelid plastic with three points at the same period

目的探讨改良微创横切纵缝内眦赘皮矫正在同期三点重睑成形术中的应用效果。方法对87例单睑轻、中度内眦赘皮患者采用改良横切纵缝内眦赘皮矫正，在新的内眦点及下泪点之间沿睑缘做曲线切口，皮下分离后去除错位异构的眼轮匝肌，折叠缝合内眦韧带浅头或将内眦韧带浅头缝合于鼻侧筋膜，皮肤重新调整后缝合内眦切口；常规行三点重睑成形术，但重睑切VI与内眦切口不相连续，呈皮下隧道相通，隧道内眼轮匝肌予以剪除。结果随访3～24个月，87例患者新内眦外形良好，瘢痕不明显，重睑线自然流畅，上睑与内眦无线形瘢痕相连，内眦赘皮无复发。结论改良微创横切纵缝内眦赘皮矫正同期行三点重睑成形术，是矫治单睑伴内眦赘皮一种简单有效的可行方法。

Obiective To assess the effect of modified minimally-invasive transverse-vertical epicanthoplasty in double-eyelid plastic with three points at the same period. Methods 87 cases with mild or moderate epicanthus and oriental eyelid were involved in our research. Epicanthoplasty was performed based on the principle of transverse- vertical plasty. The curvilinear incision of epicanthoplasty was made between the desired point of the new medial can- thus and the lower lacrimal point, the malpositioned orbicularis oculi muscle excised after skin undermining, the superfieial head of the medial eanthal tendon plicated or anchored to the lateral nasal aponeurosis and the incision closed after skin redraping. Double-eyelid plastic with three points was performed as usual, however, the incision of eyelid plastic was connected with the incision of epieanthoplasty by skin tunnel in which a strip of orbicularis oculi muscle was excised. Results 87 cases were followed-up for 3 to 24 months. The cosmetic results of the new medial canthi were satisfactory with new figure and inconspicuous scar. The contours of the double eyelids were natural. No incisional scar presented between the medial canthi and the upper eyelids. No recurrence of epicanthus was observed. Conclusion The modified mini-incisional transverse-vertical epicanthoplasty together with double-eyelid plastic with three points is a simple and effective feasible surgical approach for correction of epicanthus and oriental eyelid.