The Results of the Celsus-Hotz Procedure and Rotating Suture Technique in the Surgical Correction of the Epiblepharon

ABSTRACT

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.