眼轮匝肌-上睑提肌腱膜缝合重睑术同期联合不同矫正术式对中重度内眦赘皮合并单睑患者内眦间距的影响

Effects of double eyelid plasty of orbicularis oculi muscle-palpebralis aponeurosis suture combined with different corrective surgery on innercanthal distance in patients with moderate to severe epicanthus and single eyelid

目的研究眼轮匝肌-上睑提肌腱膜缝合重睑术同期联合不同矫正术式对中重度内眦赘皮合并单睑患者内眦间距的影响。方法回顾2019年1月~2020年1月于本院就诊的105例中重度内眦赘皮合并单睑患者病例,所有患者均接受眼轮匝肌-上睑提肌腱膜缝合重睑术治疗,其中50例患者同期联合"一"字横切法矫治,作为A组;55例患者同期联合改良"Z"成形术矫治,作为B组。比较两组患者术后6个月时内眦间距(ICD)、睑裂长度(HLFL)、HLFL/ICD值、并发症的发生以及术后7d、术后1个月、术后3个月、术后6个月温哥华瘢痕量表(VSS)评分。结果两组术后内眦赘皮恢复情况及并发症发生率比较,差异均无统计学意义(P>0.05);A组术后7d、1个月、3个月时VSS评分与B组比较,差异无统计学意义(P>0.05),A组术后6个月时VSS评分高于B组(P<0.05)。结论 "一"字横切法与改良"Z"成形术矫治中重度内眦赘皮对内眦间距及术后并发症的影响无明显差异,改良"Z"成形术矫治术后瘢痕恢复情况较好。

Objective To study the effects of double eyelid plasty of orbicularis oculi muscle-palpebralis aponeurosis suture combined with different corrective surgery on innercanthal distance in patients with moderate to severe epicanthus and single eyelid.Methods A total of 105 patients with moderate to severe epicanthus and single eyelid treated in the hospital from January 2019 to January 2020 were retrospectively analyzed.All underwent double eyelid plasty of orbicularis oculi muscle-palpebralis aponeurosis suture.Among them,50 cases undergoing Yi-shape cross-cutting were enrolled as group A,while another 55 cases undergoing modified Z-shape plasty were enrolled as group B.The innercanthal distance(ICD),palpebral fissure length(HLFL),HLFL/ICD and occurrence of complications at 6 months after surgery,and scores of Vancouver Scar Scale(VSS)at 7d,1 month,3 months and 6 months after surgery were compared between the two groups.Results There was no significant difference in the recovery of epicanthus or incidence of complications between the two groups after surgery(P>0.05).There was no significant difference in VSS score group at 7d,1 month and 3 months after surgery between group A and group B(P>0.05).VSS score at 6 months after surgery in group A was higher than that in group B(P<0.05).Conclusion There is no significant difference in the effects between Yi-shape cross-cutting method and modified Z-shape plasty in the treatment of moderate to severe epicanthus on ICD and postoperative complications.And the scar recovery is better after modified Z-shape plasty.