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@#AIM: To compare the efficacy of two surgical approaches that microscopical Hotz combined with eyelid margin incision and flap translocation and pure Hotz method in correction of severe upper eyelid cicatricial entropion. <p>METHODS: Totally 84 eyes of 60 patients who underwent corrective surgery for upper eyelid trichiasis between July 2017 to July 2019 were retrospectively assessed. The patients in trial group(32 cases, 42 eyes)underwent the surgical procedure of combining Hotz with eyelid margin incision and skin flap transposition under microscope, the other group(28 cases, 42 eyes)were treated with Hotz method. The follow-up time was 12mo. Subjective symptoms, eyelid marginal position, eyelash eversion and patient satisfaction were recorded.<p>RESULTS: The surgery time of one eye in trial group was longer than that in control group(40.8±2.57min <i>vs</i> 28.5±2.64min, <i>P</i><0.01). The cure rates of 1 and 12mo in trial group were 100% and 95%, respectively. And those in control group were 95% and 76%, respectively. The cure rate of 12mo in trial group was higher than that of the control group(<i>P</i>=0.013). There was no significant difference in patient satisfaction between the two groups at 1mo after surgery(<i>Z</i>=1.1825, <i>P</i>=0.2371). 12mo after surgery, patient satisfaction in the trial group was higher than that in the control group(<i>Z</i>=3.7346, <i>P</i><0.01).<p>CONCLUSION: While it spents longer time, the procedure of combining Hotz with eyelid margin incision and skin flap transposition under microscope is reasonably successful and satisfactory in rectifying severe upper eyelid cicatricial entropion. It offers more higher cure rate than Hotz alone at long time after operation.
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PURPOSE: To compare the effect of epiblepharon surgery using the Celsus-Hotz and rotating suture techniques. METHODS: This study reviewed the records of 118 consecutive patients who underwent epiblepharon surgery. The gender distribution, the age at surgery, the clinical manifestation, the results of the surgical correction and the complications were reviewed retrospectively. In group A, a resection of the skin and orbicularis oculi muscle with a tarsal plate fixation was performed (Celsus-Hotz procedure). In group B, after a subciliary incision, several buried 8-0 nylon sutures were placed to allow adhesion between the tarsal plate and the subcutaneous tissue of the upper skin flap with a minimal resection of the pretarsal orbicularis and redundant skin (rotating suture technique). RESULTS: There were 61 males (51.7%) and 57 females (48.3%). The average age at surgery was 5.3 years and the average follow-up period was 13.8 weeks. In group A, 5 of the 62 patients had a recurrence of the cilia touch and 1 patient underwent additional surgery. In group B, 2 of the 56 patients showed a reappearance of the cilia touch and 3 patients had a postoperative transient abnormal lower lid crease, which was more prominent at the down gaze. The lower lid crease of 2 of those patients disappeared during the follow-up period. CONCLUSIONS: In the surgical correction of the epiblepharon, the results of both the Celsus-Hotz procedure and rotating suture technique were functionally pleasing. The rotating suture technique is an effective method for correcting the epiblepharon, and there were no significant differences in the recurrence rate and the improvement in visual acuity between groups A and B.