목적 : 소아의 위눈꺼풀에서 덧눈꺼풀과 동반된 안쪽눈구석주름에 대한 교정수술의 효과를 알아보고자 하였다. 대상과 방법 : 위 덧눈꺼풀로 교정 수술이 필요한 환아 중 안쪽눈구석주름이 현저하여 덧눈꺼풀교정수술만으로는 안쪽눈구석의 눈썹 찔림의 부족교정이 예상되는 환아에서 안쪽눈구석주름교정술을 같이 시행하였다. 결과 : 수술시 평균연령은 8.6세였다. 다운증후군 7명을 포함한 13명은 변형 Y-V 앞옮김술, 8명은 뿌리 Z-안쪽눈구석주름성형술을 시행받았다. 모든 환아에서 수술 후 속눈썹찔림과 각막미란이 호전되었으나 다운증후군 4명에서는 안쪽눈구석 속눈썹찔림이 남아있었다. 수술 후 3개월 이내에 변형 Y-V 앞옮김술을 시행받은 7명, 뿌리 Z-안쪽눈구석주름성형술을 시행받은 1명에서 비후성 반흔을 보였다. 결론 : 위 덧눈꺼풀 환아에서 안쪽눈구석주름이 심한 경우 덧눈꺼풀교정수술과 함께 안쪽눈구석주름성형술을 시행하여 좋은 결과를 얻을 수 있었다. 소아의 안쪽눈구석주름교정에는 뿌리 Z-안쪽눈구석주름성형술이 권장할 만한 방법이라 생각되는데 이는 안쪽눈구석주름의 적당한 교정을 하면서 수술 후 반흔이 크게 남지 않기 때문이다.

Purpose: We evaluated the surgical correction for upper lid epiblepharon and epicanthal fold. Methods: Epiblepharon repair of the upper lid and epicanthoplasty were performed for patients who had a significant epicanthal fold, by which resultant cilia-cornea touch would be expected of the epiblepharon repair alone. From June, 1998 to February, 2004, 21 patients were operated on and 7 of the patients had Down's syndrome. Results: The mean age of the patients at the time of the surgery was 8.6 years. In all the patients, the epicanthal folds were type 3, according to the Park’s classification. Thirteen patients, including Down's syndrome patients, underwent modified Y-V advancement and eight patients underwent root Z-epicanthoplasty. The cilia-cornea touch was relieved in all of the patients except for those with Down's syndrome. Hypertrophic scar was seen in 7 patients with modified Y-V advancement and in 1 patient with root Z-epicanthoplasty until postoperative 3 months. Conclusions: Epiblepharon repair along with epicanthoplasty was effective in relieving cilia-cornea touch in children with upper lid epiblepharon and significant epicanthal fold. Root Z-epicanthoplasty can be recommended for growing children, considering that it provides moderate degree epicanthal correction and does not leave noticeable scar.

Purpose: We evaluated the surgical correction for upper lid epiblepharon and epicanthal fold. Methods: Epiblepharon repair of the upper lid and epicanthoplasty were performed for patients who had a significant epicanthal fold, by which resultant cilia-cornea touch would be expected of the epiblepharon repair alone. From June, 1998 to February, 2004, 21 patients were operated on and 7 of the patients had Down's syndrome. Results: The mean age of the patients at the time of the surgery was 8.6 years. In all the patients, the epicanthal folds were type 3, according to the Park’s classification. Thirteen patients, including Down's syndrome patients, underwent modified Y-V advancement and eight patients underwent root Z-epicanthoplasty. The cilia-cornea touch was relieved in all of the patients except for those with Down's syndrome. Hypertrophic scar was seen in 7 patients with modified Y-V advancement and in 1 patient with root Z-epicanthoplasty until postoperative 3 months. Conclusions: Epiblepharon repair along with epicanthoplasty was effective in relieving cilia-cornea touch in children with upper lid epiblepharon and significant epicanthal fold. Root Z-epicanthoplasty can be recommended for growing children, considering that it provides moderate degree epicanthal correction and does not leave noticeable scar.

Down's syndrome, Epiblepharon, Epicanthal fold, Epicanthoplasty, Modified Y-V advancement, Root Z-epicanthoplasty