Surgical Correction for Pediatric Epiblepharon and Trichiasis

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Oculoplastics

Background:

• Lower eyelid epiblepharon is a common condition in Asian children, characterized by skin folds causing eyelash-to-cornea friction.
• While often resolving with age, it can persist, leading to corneal injury and irritation impacting daily life.
• Surgical intervention is the preferred method for symptomatic relief.

Purpose of the Study:

• To classify lower eyelid epiblepharon into distinct types based on the affected area.
• To tailor surgical approaches according to the epiblepharon classification.
• To evaluate the postoperative outcomes and cure rates of the tailored surgical procedures.

Main Methods:

• Classification of lower eyelid epiblepharon into medial, central, and total involvement (Type A) based on the affected area.
• Tailored surgical techniques: L-shaped excisions for Type A and crescent-shaped incisions for Types B and C.
• Evaluation of postoperative outcomes, focusing on cure rate, scar formation, and eyelid contour.

Main Results:

• The modified Hotz procedure, focusing on skin excision and aponeurosis tightening, was utilized.
• Surgical approaches were adapted based on the three classified types of epiblepharon.
• Most patients exhibited mild postoperative reactions, with no significant complications like sunken scars or double lower eyelids.

Conclusions:

• A classification system for lower eyelid epiblepharon allows for tailored surgical interventions.
• The modified Hotz procedure, with type-specific modifications, yields satisfactory results with minimal adverse effects.
• This approach effectively alleviates corneal irritation symptoms in children with persistent lower eyelid epiblepharon.