The Modified Z-Epicanthoplasty—A Stepwise and Individualized Design
The Modified Z-Epicanthoplasty—A Stepwise and Individualized Design
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DOI：
10.1097/sap.0000000000000781
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发表时间：
2017
影响因子：
1.5
通讯作者：
Dongze Lyu;Yunbo Jin;Lei Chang;Hui Chen;G. Ma;Wenxin Yu;M. Tremp;Xiaoxi Lin
中科院分区：
文献类型：
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作者：
Dongze Lyu;Yunbo Jin;Lei Chang;Hui Chen;G. Ma;Wenxin Yu;M. Tremp;Xiaoxi Lin
目的介绍一种采用逐步定制设计的内眦赘皮成形术，并回顾亚洲患者内眦赘皮褶皱治疗后的结果。设计回顾性、非比较性和介入性病例系列，并引入一种新的手术技术。参与者：48例原发性内眦赘皮褶皱的连续亚洲患者。方法回顾性分析采用渐进式z型表皮成形术的患者（平均年龄24.6±3.8岁，范围19-40岁）的病历。定期（术前、术后即刻、术后3个月、6个月、1年）评估眼间距离（ICD）、瞳孔间距（IPD）、瘢痕可见性。计算ICD与IPD的比值（ICD ratio），并评估手术疤痕的可见性。主要观察指标术后ICD比例及疤痕质量的改善。结果术前中位ICD比值为0.60（范围0.57 ~ 0.66），术后中位ICD比值降至0.57（范围0.52 ~ 0.60）。中位ICD降低率为5.6%（范围为2.6-14.1%;P < 0.001， Wilcoxon sign -rank检验）。40例（83.3%）无明显瘢痕形成或近距离观察可见瘢痕形成。8名患者（16.7%）出现了更明显的疤痕，但没有人出现需要翻修的严重疤痕。结论采用渐进式设计的改良z型上眦赘皮成形术是一种个性化的治疗上眦赘皮皱襞的有效方法。该方法学习曲线短，广泛适用于各种类型的内眦褶皱，满意率高，长期效果稳定。
Purpose To describe a medial epicanthoplasty technique using a stepwise, customized design and to review the outcome in Asian patients after the treatment of medial epicanthal fold. Design Retrospective, noncomparative and interventional case series with the introduction of a new surgical technique. Participants Forty-eight consecutive Asian patients with primary medial epicanthal fold. Methods Patient charts were reviewed from patients (mean age, 24.6 ± 3.8 years; range, 19–40 years) with a stepwise z-epicanthoplasty. The intercanthal distance (ICD), interpupillary distance (IPD), and scar visibility were evaluated at regular intervals (preoperative, immediate postoperative, 3 months, 6 months, and 1 year after the operation). The ratio of the ICD to IPD (ICD ratio) was calculated, and the visibility of the surgical scar assessed. Main Outcome Measures Postoperative improvement in ICD ratio and scar quality. Results The preoperative median ICD ratio was 0.60 (range, 0.57–0.66) and decreased to 0.57 (range, 0.52–0.60) postoperatively. The median ICD ratio reduction was 5.6% (range, 2.6–14.1%; P < 0.001, Wilcoxon signed-rank test). Forty patients (83.3%) had no visible scarring or scarring only visible under close inspection. Eight patients (16.7%) experienced a more apparent scar, but none of them developed a severe scar requiring revision. Conclusions The modified z-epicanthoplasty using a stepwise design is a customized and effective technique for the treatment of the epicanthal fold. This method has a short learning curve, is widely applicable to various types of epicanthal fold, and has a high satisfaction rate with a stable long-term result.