Surgical correction for lower lid epiblepharon using thermal contraction of the tarsus and lower lid retractor without lash rotating sutures

Abstract

Purpose To evaluate the long-term efficacy of a new surgical technique for the correction of lower lid epiblepharon using thermal contraction of the tarsus and lower lid retractor without lash rotating sutures. Methods A retrospective study was conducted on 112 eyes of 56 patients who underwent surgical correction of lower lid epiblepharon with a modified Hotz operation (group A) or a new procedure (group B). The new technique requires that thermal contraction using bipolar cautery was applied to the inferior tarsus including the pretarsal orbicularis oculi muscle and lower lid retractor to create lash rotation without additional rotating sutures. The authors compared the results from these two techniques. Results 44 eyes of 22 patients (11 boys and 11 girls) were included in group A, the average age was 5.5 years (+/- 2.2), follow-up periods were 56.9 months (+/- 7.7). Undercorrections developed in four eyes (9.1%), and epiblepharon recurred in seven eyes (15.9%). In group B, 68 eyes of 34 (20 male and 14 female) patients were included, with an average age of 5.1 years (+/- 2.5), and a mean follow-up period of 39.7 months (+/- 9.5). Epiblepharon recurred in three eyes (4.4%), and no patients were undercorrected. The recurrence and undercorrection rates were significantly lower in group B (p=0.022 and p=0.047). Conclusion The new surgical technique for the correction of lower lid epiblepharon using thermal contraction of the tarsus and lower lid retractor without lash rotating sutures was very useful and effective for the correction of epiblepharon, with good cosmetic results.