Prognosis of Upper Eyelid Epiblepharon Repair in Down Syndrome

Abstract

To evaluate the recurrence rate after upper eyelid epiblepharon repair in patients with Down syndrome. Retrospective, observational study. Total of 578 Korean children (21 with Down syndrome patients, 557 with non-Down syndrome patients), who had undergone epiblepharon repair and were followed up for more than 2 months, were included in this study. The recurrence rate was compared between two groups at 2, 6 months after surgery. Recurrence was defined as the re-appearance of cilia touching to cornea. The recurrence rate was also analyzed according to whether patients had undergone concomitant z-medial epicanthoplasty or not. Lower eyelid epiblepharon repair was performed on 22 eyelids of Down syndrome patients, and 1072 eyelids of non-Down syndrome patients. At 3 months after surgery, the recurrence rate was not significantly different between two groups (P = 1.00). Upper eyelid epiblepharon was repaired on 40 eyelids of Down syndrome patients, and 204 eyelids in non-Down syndrome patients. At 2 and 6 months after surgery, the recurrence rate was significantly higher in Down syndrome patients (27.5% and 29.4%) than non-Down syndrome patients (3.4% and 4.6%) (P = 0.000, P = 0.004, respectively). The recurrence rate of upper eyelid epiblepharon repair was not affected in both groups whether Z-epicanthoplasty was combined or not (P = 1.00 in both groups). In Down syndrome patients, the recurrence rate after upper eyelid epiblepharon repair was higher than non-Down syndrome patients. The effect of combined Z-medial epicanthoplasty was limited in both groups.