title: Modified Hotz Procedure Combined With Modified Z-Epicanthoplasty Versus Modified Hotz Procedure Alone for Epiblepharon Repair.
abstract: OBJECTIVE
  To compare the outcomes of the modified Hotz procedure alone and combined with modified Z-epicanthoplasty for correction of epiblepharon.
  
  
  METHODS
  Seventy-one Chinese patients who underwent epiblepharon repair were divided into 2 groups. In group 1, 33 patients (59 eyes) were operated on with the modified Hotz procedure. In group 2, 38 patients (71 eyes) were operated on with the modified Hotz procedure combined with modified Z-epicanthoplasty. Treatment outcomes were classified as "excellent" with no cilium-ocular surface touching, "fair" with 5 or fewer cilia-ocular surface touchings, and "poor" with more than 5 cilia-ocular surface touchings. Incision scars were evaluated by the Vancouver scar scale (VSS).
  
  
  RESULTS
  There were no significant differences in the age or sex distribution between the two groups. For group 1, the outcome was excellent for 46 eyes (78%) and fair or poor for 13 eyes (22%). For group 2, the outcome was excellent for 70 eyes (98.6%) and fair for only 1 eye (1.4%). Thus, group 2 had significantly more excellent outcomes compared with group 1 (p < 0.001). The Vancouver scar scale of the lower eyelids in group 1 was 1.10 ± 0.30 and 1.04 ± 0.20 in group 2 after correcting for the follow-up period (p = 0.292). The medial canthus Vancouver scar scale in group 2 was 1.13 ± 0.37, which was not different from the lower eyelid Vancouver scar scale (p = 0.471).
  
  
  CONCLUSIONS
  The modified Hotz procedure combined with modified Z-epicanthoplasty is more effective in correcting lower eyelid epiblepharon than the modified Hotz procedure alone. The combined procedure does not produce obvious lower eyelid or medial canthus scars.
authors.affiliation: Department of Ophthalmological Plastic Surgery, The Affiliated Eye Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Jianxin
authors.initials: J
authors.lastname: Ni
authors.forename: Congqin
authors.initials: C
authors.lastname: Shao
authors.forename: Kaiyuan
authors.initials: K
authors.lastname: Wang
authors.forename: Xi
authors.initials: X
authors.lastname: Chen
authors.forename: Shengjie
authors.initials: S
authors.lastname: Zhou
authors.forename: Hemin
authors.initials: H
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D044466:Asian People; D019882:Blepharoplasty / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005141:Eyelid Diseases / Q000151:congenital* / Q000601:surgery; D005143:Eyelids / Q000002:abnormalities* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055815:Young Adult