Modified Epiblepharon Repair Preserving Orbicularis Oculi Muscle

Area of Science:

• Ophthalmology
• Surgical Techniques

Background:

• Lower epiblepharon, an inward turning of the eyelid, can cause discomfort and visual impairment.
• Traditional surgical repair often involves debulking the orbicularis oculi muscle, potentially affecting eyelid function and appearance.

Purpose of the Study:

• To evaluate the efficacy of a modified epiblepharon repair technique that preserves the orbicularis oculi muscle.
• To assess functional success and cosmetic satisfaction following this modified surgical approach.

Main Methods:

• A retrospective review of patients undergoing modified epiblepharon repair between April 2016 and October 2018.
• The procedure involved minimal orbicularis oculi muscle removal, utilizing eyelash rotating sutures and epicanthal weakening.
• Preoperative epiblepharon severity was graded by skin fold height and cilia-corneal touch; outcomes were assessed by functional success and cosmetic satisfaction.

Main Results:

• The study included 208 eyelids from 104 patients with a mean follow-up of 5.6 months.
• Functional success was achieved in 99.0% of eyelids (206/208).
• Mild recurrence of cilia-corneal touch occurred in two cases (total epiblepharon score of 7) but did not require reoperation. Mean cosmetic satisfaction score was 8.7/10, with higher scores correlating with greater skin fold height (p=0.027).

Conclusions:

• Modified epiblepharon repair preserving the orbicularis oculi muscle is an effective treatment for lower epiblepharon of all severities.
• The technique yields excellent functional and cosmetic outcomes without the need for orbicularis oculi muscle debulking.