A Study Of The Clinical Application Of Using The Orbicularis Oculi Muscle Ring Excision For Correction Of Epiblepharon And Epicanthal Fold Simultaneously

Objective:To investigate the clinical effect of using orbicularis oculi muscle ring excision for correction of epiblepharon and epicanthal fold simultaneously.Methods:27 cases(3 males and 24 females,average 18.1 ± 1.9years old)with upper and lower eyelids epiblepharon combined with epicanthal fold who underwent orbicularis oculi muscle ring excision surgery were reviewed from October 2016 to September 2018 in the plastic surgery depertment of the First Jilin University.During the operation,the pretarsal orbicularis oculi muscle,which lied on the upper,lower eyelids and before the medial canthal ligment were partly excised.While the later canthal portion were reserved.The removed orbicularis oculi muscle was in a ring shape.Standard photographs were taken preoperatively,postoperatively and at final follow-up.Intercanthal distance(ICD),Interpuillary distance(IPD),corneal exposure area and approximate total corneal area were measured using Screen Ruler and Photoshop software.Calculating the ratio of ICD to IPD equals to ICD ratio.Meanwhile calculating the ratio of the corneal exposure area and approximate total corneal area equals to the corneal exposure ratio(CER).The changes of ICD ratio and CER were analyzed by SPSS software before and after the operation.The improvement of the operation was evaluated by ICD ratio and the CER.Results:After operation,ICD ratio decreased from 0.60±0.02 to 0.53±0.03 postoperatively(P<0.05).CER increased from 66.82%±13.74%to 79.15%±5.24%postoperatively(P<0.05).The patients were followed up for 5 to 17 months,average of 9.3±2.9 months.During the follow-up period,no complications such as ectropion,entropion,recurrence of epiblepharon,scar contracture or lacrimal canaliculus injury occurred.All patients have got symmetrical and smooth double eyelids without scar hyperplasia or lagophthalmos and the symptoms of cilia touch have got relieved at the meanwhile.Concluions:The orbicularis oculi muscle ring excision technique is a safe and effective method which could correct the both eyelids combined with epicanthus simultaneously with low recurrence rate.The hypertrophic orbicularis oculi muscle is an important cause of the epiblepharon.The orbicularis oculi muscle’s centripetal force plays an important role in the pathogenesis of epiblepharon and epicanthal fold.