Application of modified"Z"-plasty in correction of moderate and severe epicanthus

ZHOU Lina; FU Qiuyue; CHEN Hao; ZHANG Tianqi; CHEN Wei; ZHANG Shan; CHEN Gang

doi:10.3969/j.issn.1673-7040.2025.01.003

Abstract：Objective To introduce a modified"Z"-plasty in correcting moderate and severe epicanthus,and evaluate its clinical effect.Methods A total of 135 patients with moderate and severe epicanthus were selected and treated with modified"Z"-plasty.The inter-canthal distance(ICD),interpupillary distance(IPD),and ICD/IPD ratio(ICD ratio)were measured before and after surgery as the main obser-vation indicators.The POSAS score was used to evaluate the scar status at 1 month and 12 months after surgery,and comprehensively evaluate the surgical efficacy based on the patients'satisfaction and complications.Results The ICD/IPD before surgery was 0.620(range,0.550-0.670)and 0.565(range,0.490-0.600)12 months after surgery(P=0.025).All the incisions were healing by the first intention without obvious scars.The caruncle was moderately exposed,the medial canthus angle was natural,and the palpebral fissure was obviously length-ened and widened.The PSAS score,the OS AS score,and the POSAS score at 12 months after operation were statistically different compared with the scores at 1 month after operation(P＜0.05).There were no obvious complications after surgery among 135 patients.Twelve months postoperation,67 patients(49.63％)were satisfied with the outcome,35 patients(25.93％)were moderately satisfied,29 patients(21.48％)were generally satisfied,and only 4 patients(2.96％)expressed dissatisfaction.The overall satisfaction rate was calculated to be 97.04％.Conclusion The modified"Z"-plasty has the advantages of simple surgical design,convenient operation,obvious and long-lasting postoperative effects,and inconspicuous scars for moderate and severe epicanthus,and is worthy of clinical promotion.