Electrocautery를 병행한 덧눈꺼풀의 교정수술의 효과

Abstract

Efficacy of Epiblepharon Repair with electroepilation

Ji-Man Park Advisor : Prof. Seong-won Yang M.D./PhD. Department of Medicine Graduate School of Chosun University

Purpose : To evaluate the clinical efficacy of a procedure with electroepilation using a new incision line in cases of epiblepharon.

Subject and Method : This study comprises 121 eyes of 61 patients (29 males, 32 females), clinically diagnosed with epiblepharon, which were more than 2 months postoperative follow-up. In general anesthesia, 64 eyes of 32 patients, operated with conventional technique, were classified with Group A. 57 eyes of 29 patients, operated with minimal incision and electroepilation using 0.15mm fine tip and ST 501 (Dr. Oppel, Korea) were classified with Group B. In Group B, after marking the punctal position, the medial limit of the incision line was determined so as not to exceed the medial canthus, and the lateral limit was determined so as not to touch the cilia(under 2mm). The lower incision line was a folded line of skin formed after pulling the upper skin of the medial canthal area or after a downward gaze of the patient. The upper incision line was parallel to the lid margin from the medial limit and met the lower incision line at the lateral limit. After minimal incision of skin and pretarsal orbicularis muscle, transverse rotational suture were performed, and after that, cilia follicle of trichiasis was destroyed with fine tip of cautery. Based on corneal site of touching cilia, number of touched cilia, and number of trichiasis cilia, length of incision, number of rotational suture, and number of electroepilation were classified. Recurrence, number of regrowing touched cilia, reoperation and other complication were observed.

Result : Recurrence happened in three eyes, but only one of them underwent re-operation. The other 2 eyes showed weak touching not to need operation. There were no postoperative complications. In Group A, the average length of the incision is 16.45 mm, the average number of transverse rotational sutures is 2.48, and the average number of electrically cauteried cillia is 0. There was no reoperation, complication, contacted cornea with cilia and additional cillia removal. Mean follow-up period was 17.21 months. In group B, the average length of the incision is 9.77mm, the average number of rotational sutures is 1.87, and the average number of electrically cauteried cillia is 0.96. The cases of combined surgery are 4 of medial epicanthoplasty, 2 of upper blepharoplasty and 4 of both. The 2 eyes occurred that 1 cillia contact with cornea. But we observed, since the degree of contacting cornea is mild. There was no reoperation, complication and additional cillia removal. Mean follow-up period was 23.64 months.

Conclusion : This procedure with a newly designed incision line for cases of epiblepharon showed a low recurrence rate and good cosmetic results, with a reduced operation time.