A Study Of The Clinical Application Of Double Tension Release Method For Epicanthal Fold Correction

Objective: To introduce a double tension removal method for epicanthal fold correction,and the surgical effect of this method was discussed through the comparison of preoperative and postoperative eye shape data and the score of POSAS scar evaluation scale.Methods: From September 2019 to March 2021,51 patients（49females,2 males）with epicanthus corrected by double tension removal method combined with blepharoplasty in the plastic surgery department of the First Hospital of Jilin University were retrospectively analyzed.According to the severity of epicanthus,they were divided into mild,moderate and severe groups.The postoperative effects were followed up,and standardized photographs were taken.Image J software was used to measure the intercanthal distance（ICD）and the length of palpebral fissure（HLFL）during pre-operation and post-operation,the ratio of the length of palpebral fissure to intercanthal distance（HLFL / ICD）and the improvement of the ratio were calculated.The POSAS scar evaluation scale scores of patients were recorded.SPSS statistical software was used to evaluate the correction effect of this method on epicanthus.Results: 51 patients were followed up for 6 months.HLFL / ICD increased from 0.74 ± 0.01 preoperatively to 0.88 ± 0.01 postoperatively in mild epicanthus group,HLFL / ICD of moderate epicanthus group increased from 0.68 ± 0.01 before operation to 0.87 ± 0.01 after operation,and HLFL /ICD of severe epicanthus group increased from 0.64 ± 0.01 before operation to0.86 ± 0.01 after operation.Paired sample t test was performed on the three groups,and P < 0.05 was obtained,which was statistically significant,and had good improvement effect on mild,moderate and severe epicanthus.The ratio improvement of severe epicanthus（0.220 ± 0.007）was greater than that of mild epicanthus（0.136 ± 0.011）and moderate epicanthus（0.189 ± 0.007）.All patients and observers had high overall satisfaction with postoperative scar,but the overall scores of severe epicanthus（2.27 ± 0.96）and patients（2.89 ± 1.13）were higher than those of moderate epicanthus（1.57 ± 1.03）and patients（1.95± 1.07）,mild epicanthus（1.33 ± 0.89）and patients（1.67 ± 1.23）,indicating that the overall satisfaction of severe epicanthus group with postoperative scar was not as high as that of mild and moderate epicanthus group.All incisions were primary healing without infection,lacrimal duct injury,epicanthus recurrence and other complications.After operation,the intercanthal distance was shortened,the eyelid fissure was prolonged,the double eyelid shape was good,and the lacrimal gland was fully exposed.This method does not affect the double eyelid shape when correcting epicanthus,and can be flexibly adjusted according to the desired double eyelid shape of the patient.Conclusions: The double tension release method has a good correction effect on mild,moderate and severe epicanthus.The preoperative design is simple,flexible and efficient,and the postoperative effect is reliable and stable.There is no obvious complication.There is almost no obvious scar left after operation,and there is no obvious scar hyperplasia.The epicanthus is not easy to recur,and the overall satisfaction of patients is very high.