Cosmetic Comparison Between the Modified Uchida Method and the Mustarde Method for Blepharophimosis-Ptosis-Epicanthus Inversus Syndrome.

Abstract

PURPOSE:

Blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) is a rare, congenital, surgically challenging disease. We undertook an objective, functional, and cosmetic comparison between the modified Uchida procedure and the Mustarde procedure on Asian patients with BPES.

DESIGN:

This is a retrospective, comparative, interventional case series with the description of 2 surgical techniques.

PARTICIPANTS:

Twenty consecutive Japanese patients with BPES were studied.

METHODS:

The patients were assigned to either the modified Uchida or the Mustarde procedure on the basis of preoperative intercanthal distance (ICD) ratio (ICD/palpebral fissure width). Intercanthal distance and margin reflex distance were measured from photographs before and after surgery. Classifications were made according to epicanthal fold score and cosmetic score using a visual analog scale (VAS).

MAIN OUTCOME MEASURES:

The main outcome measures were postoperative improvement in ICD ratio and the VAS.

RESULTS:

Of the 20 patients, 5 underwent the modified Uchida procedure and the other 15 underwent the Mustarde procedure. The preoperative median ICD ratio was 2.0 (range, 1.9-2.5) and 2.5 (range, 2.0-3.4) for the modified Uchida and Mustarde procedures, respectively, and decreased to 1.5 (range, 1.5-1.7) and 1.6 (range, 1.5-1.8) postoperatively. The mean ICD reduction rate was 35.7% (SD, 1.0%) in the Mustarde group and 22.1% (SD, 1.3%) in the modified Uchida group (P < 0.001).The mean VAS for the modified Uchida and Mustarde procedures was 5.9 (SD, 1.3) and 2.8 (SD, 1.1), respectively, which was statistically significant (P = 0.0166).

CONCLUSIONS:

Both the modified Uchida and Mustarde procedures could effectively shorten the ICD; however, cosmetic results were significantly superior using the modified Uchida method.

• Authors: Kazuaki Yamaguchi, Keisuke Imai, Takuya Fujimoto, Makoto Takahashi, Yoko Maruyama
• Journal: Annals of plastic surgery (Ann Plast Surg) Vol. 75 Issue 5 Pg. 518-21 (Nov 2015) ISSN: 1536-3708 [Electronic] United States
• PMID: 25180952 (Publication Type: Comparative Study, Journal Article)

Topics

• Adolescent
• Adult
• Asian People
• Blepharophimosis (ethnology, surgery)
• Blepharoplasty (methods)
• Child
• Child, Preschool
• Female
• Follow-Up Studies
• Humans
• Japan
• Male
• Retrospective Studies
• Skin Abnormalities (ethnology, surgery)
• Surgical Flaps
• Treatment Outcome
• Urogenital Abnormalities (ethnology, surgery)
• Young Adult