| Objectives:First,the technique Scarless Epicanthoplasty achieves a best clinical effect with the minimum vulnus.It is a good way to improve the patients'looks and satisfy their psychological needs.However,since Double eyelidplasty is used to pull the epicanthus to the nose,this technique also at the same time cause some negative effects including an unnatural changed shape in upper eyelids,the skin below the inner canthal is not flexible as before,the surplus epicanthus shrinks and other recidivated symptoms.In view of this,it is curious to explore how to improved techniques of Double eyelidplasty and Scarless Epicanthoplasty applied in the operation.Second,clinical index are recorded by following up patients after operation observing their reactions in order to analyze the data and provide useful results for further researches.Method:There are 239 patients received Double eyelidplasty and Scarless Epicanthoplasty in the operation from July.2014 to July,2016.The researchers followed up thease patients and of course filtering those who ever have surgical operations such as augmentation rhinoplasty?canthoplasty?rhytidectomy.Specific analysis have been made by observing the degree of epicanthus and other facial status.The following factors are taken into account to make the results more accurate:i.the width selected of double eyelidplasty;ii.the incision is cut in shape of wave;iii.Whether remove the skin or not.Adobe Photoshop and iris diameter are applied to measure the date before and after the operation.Each index is calculated in three times and the average value is selected as the final results.The averaged value is selected at the end of left and right side.Indexes including HFL/ICD(HFL horizontal lid fissure length.ICD intercanthal distance and the decrease rate are also need to be calculated.Studying these calculated results,observers can analyze the effects brought by epicanthoplasty.Pictures before and after the operations will be compared with each other.Single t test will be used in the internal of the group and paired t test will be used between different groups.All the results will be scetifically showed as Mean±SD.If the calculated results p<0.05,it will be an effective value in statistics.Results:Actually,there are about 211 patients successfully followed up,helping to make the research data complete.First,these Patients are followed up for 1-19 months(9 months in average).After operation,it is founded that inner intercanthal distance(ICD)was narrowed and Lid fissure height became lengthened,1 cases of recurrence of the sympdrom of epicanthus;No Upper eyelid and other negative effects occurred.The change of intercanthal distance(ICD)before and after operation:from 70.4415.87 units(before operation)increase to 63.52±5.73 units(twelve months after operation).Compared the ICD in the period of twelve months after the operation,it can be observed that the value of the ICD was respectively narrowed 6.92±211.24units(P<0.05;paired t test).From the table I data,it can be realized that the average inercanthal distance significantly decreased as time went by:0-3months:the decrease is slight not obvious;3-6 months:the degree of decrease is much more obvious than that of 0-3 months;6-12 months:the decrease became slight and gradually became stable.Second,the change of HFL:from 48.50±2.49 units(before operation)to 51.9712.31 units(twelve months).Compared the HFL in the period of twelve months after the operation,it can be observed that the value of the HFL was respectively increased 3.47±1.17units(p<0.05;paired t test).The tendency of the decrease of HFL is in accordance with that of ICD.Namely,the period of 0-3 months and the period of 6-12 twelve months,the degree of decrease of HFL is lower and the decrease in the period of 3-6 months is higher.Third,the rate change between HFL and ICD is shown that:one week(0.83±0.05)units and twelve months(0.82±0.05)units(p<0.05;paired t test).Forth,the decrease rate of ICD after one week,3 moths,six months and twelve months are respectively shown as 5.78%?5.40%?4.58%?4.29%.The rate change between HFL/ICD and that of ICD indicates that the change of the inner intercanthal distance.The change situation of epicanthus could be identified as two levels:the slight degree and the moderate degree:First,patients after operation,part or all of the intercanthal eyelid will be exposed.The moderate level will be more obvious.One week later,the ICD of the slight level and moderate level respectively decrease by(5.63±1.43)units and(8.87±1.41)units;twelve months later,the ICD of the slight level and moderate level respectively decrease by(5.37±1.4)units and(8.46±1.4)units(p<0.05;single t test).With regard to the decrease rate of ICD:for slight level:after one week,3 moths,six months and twelve months are respectively shown as 4.33%?4.13%.3.72%.3.48%(p<0.05;single t test);for the moderate level:7.95%.7.300%?5.89%.5.49/%.Second,the ICD decrease depends on the different epicanthus and the moderate level is more obvious to be seen than that of the slight level.No matter the slight level or moderate level,the change of ICD conforms to that of the overall.The decrease change as time went by:0-3 months after operation,the ICD decreases(slight level:0.07±0.19units;moderate level:0.1±0.24units);the degree of ICD decreases higher in the period of 3-6 months after operation(slight level:(0.09±10.10units;moderate level:0.14±0.09units);the degree of ICD decreases lower in the period of 6-12 months after operation(slight level:(0.1±0.09units;moderate level:0.1710.11units)(p<0.05;single t test);the tendency of the deacrease becomes stable.Conclusion:the dissected inter canthal will be explosed partly or completely;no scars exists in the inner cantal;the double eyelidplasty operation results seems natural and the possiblity of epicanthus is recidivated is lower.The research indicates that:the technique Scarless Epicanthoplasty possess a best clinical effect with the minimum vulnus.The two techniques are easy to operated.It is a good way to improve the patients' looks and satisfy their psychological needs.It will be valuable for future medical exploration. |
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