Abstract
BackgroundTransconjunctival fat repositioning is the gold standard for thecorrection of tear trough deformity. For fixation of fat pedicle, the internalfixation (IF) and externalized percutaneous suture (EPS) techniques are used, whichhave their own advantages and disadvantages. The present study aimed to introduce anew IF technique using a devised needle (EZ-Tcon) and to compare its outcomes withthose of the conventional EPS technique.MethodsPatients with primary tear trough deformity who underwenttransconjunctival fat repositioning were reviewed and categorized into two cohortsaccording to the fixation technique: cohort 1 consisted of patients treated using theconventional EPS technique and cohort 2 consisted of those in whom the new IFtechnique using EZ-Tcon was adopted. Post-operative complications and aestheticoutcomes were assessed using a four-scale grading system.ResultsA total of 545 patients, 211 from cohort 1 and 344 from cohort 2 wereevaluated with a median follow-up of 70 days. Compared to cohort 1, cohort 2 showedsignificantly lower rates of long-standing conspicuous scars on lower eyelid,re-operation and overall complications. In the analysis of aesthetic outcomes, 88.9percent of cohort 2 showed grade 0 (no deformity) or I (mild deformity)post-operatively. The rate of excellent outcomes (improvements of ≥ two grades) wassignificantly higher in cohort 2 than in cohort 1 (p-value < 0.001).ConclusionOur technique using EZ-Tcon could possess advantages of the conventionalIF and EPS techniques, showing lower complication rates and aestheticallysatisfactory outcomes, and could be a safe and reliable method of transconjunctivalfat repositioning.Level of Evidence IVThis journal requires that authorsassign a level of evidence to each article. For a full description of theseEvidence-Based Medicine ratings, please refer to the Table of Contents or the onlineInstructions to Authorswww.springer.com/00266.
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