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Modified everting sutures: an alternative treatment for mild to moderate epiblepharon
  1. Stephanie M Young1,
  2. Yoon-Duck Kim2,
  3. Kyung In Woo2
  1. 1 Department of Ophthalmology, National University Hospital, Singapore, Singapore
  2. 2 Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
  1. Correspondence to Dr Yoon-Duck Kim, Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea;{at}


Purpose To describe a modified everting suture procedure which can be used in patients with mild to moderate epiblepharon who are undergoing general anaesthesia for surgical correction of coexisting ophthalmic conditions.

Methods A prospective, interventional, non-comparative case series on patients with mild to moderate epiblepharon who underwent the modified everting suture procedure using permanent nylon sutures while under general anaesthesia for other ophthalmic surgery, from May 2014 to May 2016, in a single tertiary institution. Main outcome measures were correction of epiblepharon, recurrence rate and complications.

Results There were a total of 29 patients. Mean age was 5.7±4.1 years (range 1.5–20 years). Twenty (69.0%) were male, 31.0% were female. All had concomitant surgery under general anaesthesia for levator resection (75.9%), frontalis sling (17.2%), strabismus surgery (3.4%) and coloboma correction (3.4%). Mean follow-up was 18.1±9.1 months. All patients were well corrected at 1 and 6 months postoperative follow-up. At 1 year after surgery, 28 (96.6%) were well corrected while one patient (3.4%) was undercorrected. At last follow-up, the overall recurrence rate was 6.9%, with a mean time from surgery to recurrence of 20.5 months. There were no complications encountered.

Conclusions The modified everting suture procedure is a safe, effective, quick and relatively easy procedure for selected patients with mild to moderate epiblepharon, who are undergoing general anaesthesia for surgical correction of their coexisting ophthalmic conditions.

  • eyelids
  • treatment surgery

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  • Contributors All authors have made substantial contributions to the (1) conception of the work, (2) the acquisition, analysis or interpretation of data, (3) drafting the work or revising it critically for important intellectual content and (4) final approval of the version published. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The manuscript has been read and approved by all the authors, and the requirements for authorship as stated above have been met.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Parental/Guardian consent obtained.

  • Ethics approval Samsung Medical Center Institutional Review Board.

  • Provenance-and-peer-review Not commissioned; externally peer reviewed.

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