Surgical Correction for Upper Lid Epiblepharon and Epicanthal Fold in Children

ABSTRACT

PURPOSE: We evaluated the surgical correction for upper lid epiblepharon and epicanthal fold. METHODS: Epiblepharon repair of the upper lid and epicanthoplasty were performed for patients who had a significant epicanthal fold, by which resultant cilia-cornea touch would be expected of the epiblepharon repair alone. From June, 1998 to February, 2004, 21 patients were operated on and 7 of the patients had Down's syndrome. RESULTS: The mean age of the patients at the time of the surgery was 8.6 years. In all the patients, the epicanthal folds were type 3, according to the Park's classification. Thirteen patients, including Down's syndrome patients, underwent modified Y-V advancement and eight patients underwent root Z-epicanthoplasty. The cilia-cornea touch was relieved in all of the patients except for those with Down's syndrome. Hypertrophic scar was seen in 7 patients with modified Y-V advancement and in 1 patient with root Z-epicanthoplasty until postoperative 3 months. CONCLUSIONS: Epiblepharon repair along with epicanthoplasty was effective in relieving cilia-cornea touch in children with upper lid epiblepharon and significant epicanthal fold. Root Z-epicanthoplasty can be recommended for growing children, considering that it provides moderate degree epicanthal correction and does not leave noticeable scar.