应用改良Hotz法结合改良Y-V法矫治不同严重程度的先天性睑内翻合并内眦赘皮疗效观察OA

Objective To explore the application effect of modified Hotz method combined with modified Y-V method on patients with congenital entropion complicated with epicanthus of different severities.Methods A total of 95 patients(190 eyes)with congenital entropion and epicanthus in the hospital were selected from January 2022 to January 2025.According to the evaluation of severity of congenital entropion with epicanthus by means of the range of entropion and trichiasis and the occlusion degree of lacrimal caruncle by epicanthus,the patients were divided into mild group(n=35,70 eyes),moderate group(n=32,64 eyes)and severe group(n=28,56 eyes).All patients were treated with modified Hotz method combined with modified Y-V method,and were followed up for 3 months and 6 months after surgery.The differences in eyelid anatomical structure indexes[Inner Canthic Diameter(ICD),Horizontal Lid Fissure Length(HLFL)],Vancouver Scar Scale(VSS),aesthetic effect[Observer Scar Assessment Scale(OSAS),Patient Scar Assessment Scale(PSAS)],incidence rates of complications and recurrence rate at 6 months after surgery were compared among the three groups of patients.Results Before surgery and at 6 months after surgery,the ICD level in the three groups of patients revealed mild group＜moderate group＜severe group,while the HLFL level showed mild group＞moderate group＞severe group(P＜0.05),and the ICD in the three groups of patients at 6 months after surgery was reduced compared with that before surgery while the HLFL level was enhanced(P＜0.05).At 3 months and 6 months after surgery,the scores of VSS dimensions(color,softness,vascular distribution and thickness)in the three groups of patients were manifested as mild group＜moderate group＜severe group,and the VSS scores in the three groups of patients at 6 months after surgery were lower than those at 3 months after surgery(P＜0.05).At 3 months and 6 months after surgery,the OSAS score and PSAS score in the three groups were shown as mild group＜moderate group＜severe group,and the OSAS score and PSAS score in the three groups of patients were decreased at 6 months after surgery compared with those at 3 months after surgery(P＜0.05).Within 6 months after surgery,the incidence rates of complications in severe group were higher than those in moderate group and mild group(P＜0.05),and there was no statistical significance in the recurrence rate among the three groups(P＞0.05).Conclusion Modified Hotz method combined with modified Y-V method has a significant correction effect on congenital entropion with epicanthus of different severities,but the anatomical structure recovery and scar aesthetics of severe patients still need to be optimized,and the incidence rates of complications are relatively high,suggesting that perioperative intervention should be strengthened for severe patients to enhance the efficacy.