title: Blepharoplasty with a Buried Double Twisted Suture Technique to Correct Upper Eyelid Epiblepharon.
abstract: BACKGROUND
  The authors evaluated the clinical efficacy of blepharoplasty using a newly developed, buried double twisted suture (BDTS) technique to correct upper eyelid epiblepharon.
  
  
  METHODS
  This retrospective study was conducted from October 2013 to July 2015 at the Oculoplastic Clinic, Bundang CHA Medical Center, CHA University, Seongnam, Korea. A total of 122 eyes from 61 patients with upper eyelid epiblepharon were enrolled. Blepharoplasty with a BDTS technique was performed on all eyes, followed by evaluation of clinical outcomes and complications. After surgery, success was defined as the persistence of a double eyelid and the upper eyelid eyelashes not touching the cornea under slit lamp examination.
  
  
  RESULTS
  The 61 patients were composed of 29 females and 32 males. The average age was 9.0 ± 7.7 years, and the average follow-up period was 7.3 ± 5.2 months. After surgery, the margin reflex distance increased from 2.0 ± 1.0 to 3.2 ± 0.9 mm (P < 0.05). The success rate was 98.1%. Epiblepharon recurred in 1 patient (1.9%) and was treated after 2 months. Knot exposure was a postoperative complication in 2 patients (3.8%). The knots were buried in the deep layer under local anesthesia. Overall, all cases showed good results without complications.
  
  
  CONCLUSIONS
  Blepharoplasty with a BDTS technique is relatively simple and effective for correction of epiblepharon with a low rate of complications. This technique can be applied to double eyelid surgery based on the excellent cosmetic outcomes.
authors.affiliation: Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea; and Division of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, Calif.
authors.forename: Seung Woo
authors.initials: SW
authors.lastname: Choi
authors.affiliation: Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea; and Division of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, Calif.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Goldberg
authors.affiliation: Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea; and Division of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, Calif.
authors.forename: Helen
authors.initials: H
authors.lastname: Lew