Introduction: Postoperative recurrence is common following surgery in patients with epiblepharon and co-existing epicanthal folds. We report the results of using combined epicanthoplasty and modified Hotz's procedure techniques aimed at correcting the structural anomalies and improving surgical out-come.
Methods: We performed combined epicanthoplasty and modified Hotz's procedure procedures on 5 patients (10 eyelids) between May 2007 and October 2008. The surgical procedures involved redraping the medial canthal skin folds using Uchida's method in 4 patients and Z-plasty in 1 patient.
Result: Epiblepharon was resolved following surgery, and the symptoms improved immediately. The preoperative pathognomonic appearance with the nasal conjunctiva almost hidden by the epicanthus changed, and the nasal conjunctiva became visible postoperatively. There were no signs of recurrence at postoperative follow up (range, 6-20 months, mean 9.4 months).
Conclusion: Combined epicanthoplasty and modified Hotz's procedure produced good postoperative results, with no signs of recurrence. However, lack of experience in skin flap design and inappropriate surgical manipulation could lead to unsightly scar formation and adverse cosmetic results. We therefore recommend that epicanthoplasty be decided by experts in oculoplastic surgery.