Epiblepharon in Chinese children: relationships with body mass index and surgical treatment

J AAPOS. 2016 Apr;20(2):148-52. doi: 10.1016/j.jaapos.2015.12.009.


Purpose: To evaluate the relationship between the incidence of lower eyelid epiblepharon and body mass index in Chinese children and report the outcomes of a rotating suture technique or the L-plasty procedure aimed at correcting the structural anomalies.

Methods: The medical records of patients treated surgically, with either rotating suture procedure or L-plasty, for lower eyelid epiblepharon were reviewed retrospectively and compared with an age-matched control group of children without epiblepharon. Body mass index (BMI) was calculated as weight in kilograms divided by the square of height in meters.

Results: A total of 67 patients (mean age, 5.7 ± 2.6 years) and 178 controls were included. All patients had coexistent epicanthus. In 62 patients, rotating suture procedures were used; in 5, L-plasty. The BMI in 4- to 6-year-old boys with epiblepharon was significantly higher than that in children without epiblepharon (P = 0 .042). All patients showed successful surgical outcomes according to improvement of symptoms and lack of cilia-cornea contact. There were no cases of recurrence or other complications.

Conclusions: Obesity may be an aggravating factor in cases of lower eyelid epiblepharon, which may be corrected effectively with the rotating suture procedure and the L-plasty procedure. The L-plasty procedure is recommended for patients with coexistent severe epicanthus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Asian People / ethnology*
  • Blepharoplasty / methods*
  • Body Mass Index*
  • Child
  • Child, Preschool
  • Eyelid Diseases / congenital*
  • Eyelid Diseases / diagnosis
  • Eyelid Diseases / ethnology
  • Eyelid Diseases / surgery
  • Eyelids / abnormalities*
  • Eyelids / surgery
  • Female
  • Humans
  • Infant
  • Male
  • Obesity / diagnosis*
  • Obesity / ethnology
  • Obesity / surgery
  • Retrospective Studies
  • Risk Factors
  • Surgical Flaps
  • Suture Techniques

Supplementary concepts

  • Epiblepharon of Upper Lid