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Hu S, Li J, Lu Y, Zhao S, Shao Y. Minimal lower eyelid epicanthoplasty combined with thermal contraction to treat epiblepharon in chinese children. BMC Ophthalmol 2023; 23:18. [PMID: 36627593 PMCID: PMC9832807 DOI: 10.1186/s12886-022-02763-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 12/28/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND To evaluate the clinical efficacy of combined minimal lower eyelid epicanthoplasty and thermal contraction for epiblepharon repair in Chinese children. METHODS Between January 2017 and August 2020, a single surgeon corrected epiblepharon in Chinese children using minimal lower eyelid epicanthoplasty combined with thermal contraction. First, a minimal epicanthoplasty flap to balance the lower eyelid was made cross the lower eyelid epicanthus, which connected with a 20-mm-long incision 1.5 mm below the lower eyelid margin. After removing the hypertrophic orbicularis oculi muscle running between the lower epicanthal fold and the medial canthal tendon, thermal cauterization was applied to increase lower eyelid rotation by creating adhesions between the lower eyelid retractor and tarsus. The residual medial edge was sutured to the corner of the epicanthus to decrease the lower eyelid epicanthus. The postoperative follow-up ranged from 3 to 24 months. We retrospectively analyzed cases to determine whether this approach decreased the lower eyelid epicanthal fold to equalize the tension of the lower eyelid. The surgical outcomes including the direction of lower eyelid eyelashes, complications, and refractive errors were evaluated. RESULTS Data from each eye of 53 Chinese children (29 female, 24 males; mean age: 5.3 ± 2.3 years) who had undergone minimal lower eyelid epicanthoplasty combined with thermal contraction were included. During follow-up, recurrence was observed in just one of the 106 eyes (0.94%), and two eyes (1.89%) showed under-correction. No visible scars formed in the postoperative period. All patients' parents were satisfied with the cosmetic results and had no serious complaints. The mean astigmatism was significantly reduced by the surgery from 1.82 ± 0.45 diopters (D) preoperatively to 1.43 ± 0.36 D postoperatively (P < 0.05). CONCLUSION This surgery is easy to design, time-efficient, and is effective in the correction of epiblepharon. The procedure allows surgeons to achieve good appearance and natural eyelid contour without apparent complications.
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Affiliation(s)
- Shoulong Hu
- grid.24696.3f0000 0004 0369 153XNational Center for Children’s Health, MOE Key Laboratory of Major Diseases in Children, Department of Ophthalmology, Beijing Children’s Hospital, Capital Medical University, Beijing, 100045 China ,Department of Ophthalmology, Children’s Hospital of Zheng Zhou, Zheng Zhou, 450053 China
| | - Jingyi Li
- grid.460676.50000 0004 1757 5548Department of Endocrinology, Beijing United Family Hospital, Beijing, China
| | - Yuebing Lu
- Department of Ophthalmology, Children’s Hospital of Zheng Zhou, Zheng Zhou, 450053 China
| | - Shengnan Zhao
- Department of Ophthalmology, Children’s Hospital of Zheng Zhou, Zheng Zhou, 450053 China
| | - Yi Shao
- grid.412604.50000 0004 1758 4073Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi Province 330006 China
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Lee JH, Kim SE, Byun YS, Yang SW. Comparing Changes in Corneal Astigmatism Using Scheimpflug Camera after Epiblepharon Correction Surgery. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2022. [DOI: 10.3341/jkos.2022.63.3.221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: To evaluate the changes in corneal astigmatism before and after epiblepharon correction surgery with a Scheimpflug camera.Methods: From April, 2019, to June, 2020, 48 eyes of 24 patients underwent epiblepharon correction surgery. The patients were divided into two subgroups by age and their best corrected visual acuity (BCVA) and corneal anterior and posterior astigmatism were compared before and after correction surgery.Results: There was no difference in BCVA after the correction surgery. To assess the changes in the keratometric value and astigmatism after epiblepharon surgery, a Scheimpflug camera was used. The anterior flat and mean keratometry changed from 42.10 ± 1.46 to 42.43 ± 1.10 D (p = 0.035) and from 42.97 ± 1.26 to 43.21 ± 1.15 D (p = 0.012), respectively, while the posterior corneal astigmatism changed from 0.44 ± 0.31 to 0.35 ± 0.17 D (p = 0.047). There were no significant changes in steep keratometry (p = 0.191) or anterior corneal astigmatism (p = 0.126).Conclusions: There were significant changes after epiblepharon correction surgery in anterior keratometry reading and posterior corneal astigmatism.
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Effect of upper eyelid blepharoplasty on corneal biomechanical, topographic and tomographic parameters 4 weeks after surgery. Int Ophthalmol 2021; 42:113-121. [PMID: 34478004 PMCID: PMC8803703 DOI: 10.1007/s10792-021-02006-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 08/07/2021] [Indexed: 11/11/2022]
Abstract
Purpose To investigate the effect of “skin-only” upper eyelid blepharoplasty on corneal biomechanics and central as well as peripheral topographic/tomographic parameters before and 4 weeks after surgery. Methods In a prospective study, the corneal hysteresis (CH) and corneal resistance factor (CRF) were evaluated before and after blepharoplasty. Corneal topographic (maximum simulated keratometry value, inferior-superior value, index of surface variance, index of vertical asymmetry, index of height asymmetry, index of height decentration) and tomographic parameters (corneal thickness, corneal astigmatism and mean 5-mm- and 7-mm-zone keratometry value) were measured by the Pentacam HR. Statistical analysis was performed using a linear mixed model considering correlated data of both eyes. Results This study included 42 eyes of 35 patients (mean age: 64.5 years, range 52–82 years). Four weeks after surgery CH and CRF increased (9.4 ± 2.3 to 10.2 ± 2.2 mmHg and 9.7 ± 2.1 to 10.5 ± 2.2 mmHg) but did not reach statistical significance (P = 0.100 and P = 0.072). A significant increase in central maximum simulated keratometry value (Kmax) from 45.0 ± 2.3 to 45.4 ± 2.2 diopters (D) was observed (P = 0.004). Inferior-superior value (I-S) and index of surface variance (ISV) showed significant changes from 0.32 ± 0.98 to 0.10 ± 0.98 D (P = 0.02) and from 19.98 ± 9.84 to 22.93 ± 11.23 (P = 0.009), respectively. These alterations did not affect the subjective spherical equivalent (-0.09 ± 4.71 to -0.04 ± 4.51 D; P = 0.437) and the best-corrected distance visual acuity of patients (0.11 ± 0.14 to 0.15 ± 0.15 logMAR; P = 0.142). Age, gender and corneal thickness were not correlated with pre and postoperative differences of CH, CRF, corneal compensated IOP, Kmax, corneal astigmatism or I-S. Conclusion The trend of increasing CH and CRF values might indicate a rise of corneal damping capacity. Despite statistically significant differences of Kmax, I-S and ISV, all other tomographical and topographical parameters did not change 4 weeks after surgery. The corneal steepening with a mean change of 0.4 diopters and the decrease of I-S with a mean of 0.22 diopters do not seem to have a clinically relevant effect for blepharoplasty patients in daily practice.
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Kim Y, Lee JH. Association of blepharoptosis with refractive error in the Korean general population. Eye (Lond) 2021; 35:3141-3146. [PMID: 34262163 DOI: 10.1038/s41433-021-01652-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/28/2021] [Accepted: 06/16/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND/OBJECTIVES We investigated the effect of blepharoptosis on refractive errors across different age groups in Korean population. SUBJECTS/METHODS This cross-sectional study was performed with data obtained in the Korea National Health and Nutrition Examination Survey (KNHANES) from 2008 to 2012. A total of 33,103 participants were enroled in our study. Blepharoptosis was defined as a marginal reflex distance 1 (MRD1) less than 2 mm, and was diagnosed in 3,305 (9.98%) participants. Ophthalmic examinations were performed, including measurements of MRD1, spherical equivalent, and degree of astigmatism. The age range was divided into three groups: less than 20 years old; more than 20 years and less than 60 years old; and more than 60 years old. RESULTS The mean spherical equivalent were -0.28 ± 2.23 D in the ptotic eyelids and -1.13 ± 2.30 D in the non-ptotic eyelids (p < 0.001, 95% CI: -0.93, -0.77). The mean cylinder dioptre were -1.03 ± 0.87 D and -0.80 ± 0.77 D respectively (p < 0.001, 95% CI: 0.20, 0.26). The association with the eyelid position and refractive error significantly differed according to the age group and body mass index. Increased positive spherical change and increased astigmatism were prominent among ptotic participants aged less than 60 years. CONCLUSIONS A decrease in MRD1 was associated with a hyperopic shift and higher astigmatism. Mechanical compression of the ptotic eyelid may affect ocular biometry, with the effect being particularly prominent in younger participants who had greater eyelid tension.
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Affiliation(s)
- Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Ju-Hyang Lee
- Department of Ophthalmology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.
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Hu SL, Shi WQ, Su T, Ge QM, Li QY, Li B, Liang RB, Zhu PW, Shao Y. Surgical correction of recurrent epiblepharon in Chinese children using modified skin re-draping epicanthoplasty. Int J Ophthalmol 2021; 14:217-222. [PMID: 33614449 DOI: 10.18240/ijo.2021.02.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 04/03/2020] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate the clinical efficacy of the modified skin re-draping epicanthoplasty procedure for correction of recurrent lower lid epiblepharon in Chinese children. METHODS From 2016 to 2018, 18 children (10 males and 8 females, average age 6.2±1.7y; 30 eyes) with recurrent epiblepharon who attended Beijing Children's Hospital were included in the study. All the children had undergone lower eyelid surgery for epiblepharon. Surgical design included using an additional incision along the upper palpebral margin, to avoid vertical scarring on the upper lid. The re-draping method was used to correct recurrent epiblepharon. Follow-up ranged from 3 to 24mo. Postoperative surgical outcomes, complications, and subjective satisfaction were evaluated. RESULTS Complete correction of cilia touching the cornea was observed in all patients during an average follow-up of 7.1mo. No "dog ears" or obvious scars were formed after surgery. All parents were satisfied with the cosmetic results and none complained. Mean astigmatism decreased from 2.39±0.79 diopter (D) preoperatively to 2.19±0.79 D at 6mo after surgery; however, the difference was not significant. Best-corrected visual acuity improved, although the change in mean visual acuity was not significant. No recurrence occurred during the follow-up period. CONCLUSION This surgical modified skin re-draping technique is effective and highly satisfactory for correction of recurrent epiblepharon. The approach is characterized by a simple design, a straightforward procedure, inconspicuous scarring, and good postoperative appearance.
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Affiliation(s)
- Shou-Long Hu
- National Center for Children's Health, MOE Key Laboratory of Major Diseases in Children, Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - Wen-Qing Shi
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang 330006, Jiangxi Province, China
| | - Ting Su
- Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, School of Medicine, Xiamen University, Xiamen 361102, Fujian Province, China.,Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston 02114, USA
| | - Qian-Min Ge
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang 330006, Jiangxi Province, China
| | - Qiu-Yu Li
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang 330006, Jiangxi Province, China
| | - Biao Li
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang 330006, Jiangxi Province, China
| | - Rong-Bin Liang
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang 330006, Jiangxi Province, China
| | - Pei-Wen Zhu
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang 330006, Jiangxi Province, China
| | - Yi Shao
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang 330006, Jiangxi Province, China
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