title: Structural and cosmetic outcomes of medial epicanthoplasty: An outcome study of three different techniques.
abstract: OBJECTIVE
  The authors intended to evaluate the structural and cosmetic outcomes of medial epicanthoplasty.
  
  
  METHODS
  Medical records and photographs of 92 eyes from 46 Korean patients who underwent medial epicanthoplasty were reviewed retrospectively. The patients underwent epicanthoplasty using root Z-plasty, Y-V plasty, Mustarde's technique, and modified one-armed Mustarde's technique, from January 2009 to August 2011. Postoperative changes in the horizontal fissure width were measured for the assessment of structural outcome. The cosmetic outcomes were assessed in terms of appearance, symmetry, and scarring using a three-point grading system. Postoperative outcomes were evaluated at 1, 3, and 6 months after surgery.
  
  
  RESULTS
  Root Z-plasty, Y-V plasty, and Mustarde's method (including Mustarde's technique and modified one-armed Mustarde's technique combined) with medial canthopexy were performed on 64, 13, and 15 eyes, respectively. Six months after surgery, the horizontal fissure width increased by an average of 1.74 (8.4%), 1.64 (8.9%), and 1.89 mm (12.9%), respectively (p < 0.001, 0.041, and 0.027). In addition, root Z-plasty had a higher postoperative appearance grade than Y-V plasty and Mustarde's method (p < 0.001). Grades of symmetry were good for all methods, and grades of scarring were good for root Z-plasty and fair for the others. Scarring was significantly improved until postoperative 6 months in root Z-plasty and Y-V plasty (p < 0.001 and p = 0.022, respectively).
  
  
  CONCLUSIONS
  Medial epicanthoplasty increased the horizontal fissure width of about 1.7 mm. Most cosmetic outcomes were satisfactory, with root Z-plasty resulting in excellent outcomes. Scarring faded over time.
authors.affiliation: Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: ecykim@yuhs.ac.
authors.forename: Chang Yeom
authors.initials: CY
authors.lastname: Kim
authors.affiliation: Lee Eye Plastic Clinic, Seoul, Republic of Korea.
authors.forename: Sang Yeul
authors.initials: SY
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D016569:Blepharophimosis / Q000601:surgery*; D019882:Blepharoplasty / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004774:Entropion / Q000601:surgery*; D005143:Eyelids / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cosmetic outcomes; Epicanthal folds; Horizontal fissure width; Medial epicanthoplasty; Scarring