Reduction in Recurrence Rate by Combining Modified Hotz Procedure With Epicanthoplasty to Treat Congenital Epiblepharon.

Aim: To determine whether patients with congenital lower lid epiblepharon treated with a modified Hotz procedure combined with epicanthoplasty have a decreased recurrence rate.

Patients And Methods: Patients with epiblepharon of the lower eyelid corrected using a modified Hotz method between 2007 and 2017 were evaluated retrospectively by chart review to determine rates of complications and recurrence as well as whether the Hotz method was combined with epicanthoplasty. The recurrence rates for patients treated with the Hotz method alone or in combination with epicanthoplasty were compared.

Results: A total of 60 patients (mean age, 13.6 years) and 115 eyelids were evaluated. All patients showed improvement in their symptoms and had no complications. Across the entire group, the recurrence rate for entropion was 23.5% (27 eyes). A modified Hotz procedure combined with epicanthoplasty was performed on 43 (37.4%) eyes. The recurrence rate for the group treated with a modified Hotz procedure combined with epicanthoplasty was significantly lower than that for patients who underwent the Hotz procedure alone (7.0% vs 33.3% P = 0.0012). There was no relationship between epicanthus severity and recurrence rate (P = 0.345).

Conclusion: In this study, we showed that patients who underwent a modified Hotz procedure combined with epicanthoplasty had a decreased recurrence rate. This improved outcome could be due to the simpler approach to the nasal side of the lower eyelid in epicanthoplasty, and epicanthoplasty can facilitate detachment of the upper eyelid from the lower eyelid.