Abstract
To report the experience and advantageous effects of high-frequency radio wave electrocautery in modified Hotz operations for epiblepharon, We reviewed the records of all pediatric patients who underwent a modified Hotz operation with the use of high-frequency radio wave electrocautery (Ellman Surgitron Dual Frequency RF S5; Ellman International, Inc, Hewlett, NY) for epiblepharon between March 2016 and September 2019 at Korea University Guro Hospital. We evaluated the success rate, complications, recurrence rate and degree of satisfaction of our technique. Information from the medical records was collected, including demographics, ocular symptoms, severity of keratopathy, operation time, success/recurrence rate, and complications. 133 patients (98.52%) showed good correction of epiblepharon without complications or unpleasant cosmetic problems during 3 months of median follow-up period. Two patients (1.48%) showed recurrent corneociliary touch, but the degree was very mild and re-operation was not performed. One patient showed mild ectropion on his left lower eyelid, but the patient recovered well without operation. For complications, suture abscess and granulation were the most common, 3 cases in each, but all of those were temporary and resolved with conservative management. The approach with electrocautery for epiblepharon allows precise and fast incision of the lower eyelid, little bleeding, and minimal scarring. Surgical outcomes associated with the modified Hotz operation with electrocautery were consistent with previous studies.
Highlights
Electrosurgical devices have developed since Dr Albrecht Theodor Middeldorf first discussed and published application of electrical current in surgical interventions in 1854
Epiblepharon is defined as a horizontal fold of skin and underlying orbicularis muscle that override the eyelid margin and push the lashes against the globe [5]
Noda et al reported that mild epiblepharon can be treated with a conservative approach, after which the condition can spontaneously improve over time [14]
Summary
Electrosurgical devices have developed since Dr Albrecht Theodor Middeldorf first discussed and published application of electrical current in surgical interventions in 1854. Irving Ellman determined that a 4 MHz frequency electrocautery produced the smoothest cutting effects on tissue while limiting uncontrolled thermal damage [1]. Stephen Bosniak introduced the radioelectrical device for his oculoplastic surgery approach in 1985. High-frequency radio wave electrocautery has since been. Epiblepharon is defined as a horizontal fold of the skin and underlying orbicularis muscle that overrides the eyelid margin and pushes the lashes against the globe [5]. Corneociliary touch in epiblepharon causes keratopathy, and patients can experience tearing, photophobia, foreign body sensation, and visual disturbance [6]. Surgical treatment is pursued in severe cases with significant corneal injury.
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