睫毛下缘切口内眦赘皮矫正术

Epicanthus correction by subciliary incision epicanthoplasty

目的探讨在横切法矫正内眦赘皮基础上，寻求一种既能充分开大内眦角，又能使切口瘢痕不明显、外形美观的手术方法，并就其近期效果和远期效果进行综合评价。方法以内眦赘皮底面的泪阜最内侧位置在赘皮表面的投影点为新的内眦角点，由此点向赘皮游离缘水平全层剖开皮肤，并继续沿下睑睫毛下方向外延伸皮肤切口，分离皮肤，松解或剪除皮下部分错位的眼轮匝肌纤维，消除内眦部皮肤张力后，重置内眦部皮肤，将原内眦角与新内眦点缝合，其余皮肤妥善对位缝合。结果随访120例患者，其中12例术后1个月呈轻度瘢痕增生，至6个月时瘢痕大部分自然软化，1年时瘢痕痕迹不明显；22例在术后1个月内存在内眦局部少许皮肤皱褶；2例对内眦角形态不满意；其余患者对近期治疗效果均表满意。经1年以上的远期随访，内眦赘皮矫正充分，皮肤皱褶基本消失，瘢痕不明显。结论睫毛下缘切口内眦赘皮矫正术，设计简单，内眦充分开大，瘢痕不明显，赘皮不易复发，适于矫正所有形态的内眦赘皮。

Objective To explore an operative method which can adequately enlarge the inner canthus with inconspicuous scar and perfect shape based on the transverse incision for epicanthus cor- rection, and to evaluate the short-term results and long-term effects comprehensively. Methods The surface projection of tears port medial point was designed as a new inner canthal point, the full thick- ness skin from new inner canthal point was cut to the free edge of epicanthus, and an outward pro- longed incision was made along the lower eyelid edge, separating the subcutanous dissociation or cut- ting off part of displaced orbicularis, so to relieve the skin tension of inner canthal and reset skin, su- turing the new inner canthal point and lower eyelid edge. Results 120 cases were followed up for more than one year, the complication rate at different postoperative time points and patient satisfactory rate one year after operation were compared. 12 cases had mild scar formation, from six months to one year after operation, the scar gradually became softened and then inconspicuous. 22 cases bad a little skin fold at the inner canthal in postoperational one mouth. 2 cases were unsatisfied with the shape of inner canthal, Others were satisfied with therapeutic efficacy, the correction was sufficient with incon- spicuous scar and less recrudescence. Conclusions Epicanthus correction by subciliary incision epic- anthoplasty is a simple and effective method and suitable for all types of epicanthic fold, and it has the advantages of sufficient enlarged inner canthus, inconspicuous scar and less recrudescence.