Curative Effect Analysis Of Modified Y-V Plasty In The Treatment Of Congenital Entropion With Epicanthus

Objectives:To evaluate the efficacy of modified Y-V plasty in the treatment of congenital entropion with epicanthus in children and to explore its clinical application value.Methods:This study prospectively analyzed patients with congenital entropion and epicanthus admitted to our medical group from September 2021 to December 2022,aged between 3 and 18 years.The modified Y-V plasty was used as the treatment plan,and the severity of the disease was evaluated by morphological classification(I~III grade).After the operation,the patients were followed up for at least 6months,and the data of evaluation indexes before and after the operation were compared and analyzed by statistical methods.Results:A total of 53 patients(106 eyes)were included in this study,including 25 males and 28 females,with an average age of 9.09 ± 3.8 years(4~18 years).The subjects were followed up for more than 6 months.All patients’ incisions healed well without obvious scar formation,the epiblepharon disappeared,the inner canthus angle was good and symmetrical,the ocular irritation symptoms such as photophobia and tears completely disappeared,and the cornea was transparent and smooth under slit lamp.There was no eyelash contact with the eye when the eye was looking directly or turning down,and the corneal fluorescence staining was negative.Overall,this study demonstrated that the modified Y-V plasty is effective in treating congenital entropion with epicanthus,with significant improvement in eyelash tilt angle in all grades after surgery(P<0.001).The MED was significantly reduced 6months after surgery(P < 0.01).In addition,the improvement in MED and MED/OCD were positively correlated with disease severity(P<0.001).Analysis of the POSAS score showed that the OSAS and PSAS at 6 months after surgery increased with disease grading in all groups,with statistical significance(P<0.01),except for levels II and III in the OSAS score.In the overall observer and patient scores,except for levels I and II,scores in each group also showed this trend(P<0.05).Furthermore,only one patient had a complication of incision splitting at the inner canthus,which was not treated specially due to good wound fit.After 6 months of follow-up,the incision healed well without any deformities or obvious scar formation.Conclusions:The modified Y-V plasty can effectively relieve the abnormal traction of the orbicularis oculi muscle at the inner canthus to the eyelid.The surgical effect is ideal,the operation is simple,the recurrence rate is low,and the corneal injury caused by entropion can be cured fundamentally.At the same time,the modified Y-V plasty can eliminate epicanthus and epiblepharon,significantly improve facial appearance,and usually does not leave obvious scars.