Hotz method for cicatricial blepharoplasty correction

Scar varus is caused by scar contraction of the conjunctiva or tarsal plate, and the gingival margin is turned inward. One of the common sequelae of trachoma. It can also occur in scars left by diseases such as chemical burns or conjunctival pemphigus. Scarring varus caused by trachoma, the scar tissue of the conjunctiva, together with the tarsal plate in the lower sulcus of the tarsal plate, becomes the focus of the entire tarsal plate and the center of the scar. The seesaw is bent by traction and thickens due to trachoma infiltration. The skin and muscle layers of the eyelids are mostly free of lesions, which are only deformed as the jaws are bent and thickened. Thus, the principle of correcting this scar varus is: 1 to eliminate the traction of the center of the scar; 2 to complete the shape of the slab; 3 to restore the position of the rim. The correction surgery for scarring varus is similar to the Hotz method and the sacral cutting method. It conforms to the surgical principle described above and is a commonly used surgical method with good results. Treatment of diseases: scar stenosis, preoperative preparation The main surgical instruments include: eyelids, blades, spurs, straight cuts, curved shears, mosquito-type hemostats, needle holders, needles, sutures, etc. Surgical procedure 1. Insert the eyelid into the dome, cushion the eyelids, protect the cornea and help with bleeding during surgery. 2. At the distance of the iliac crest 3mm, cut the eyelid skin parallel to the gingival margin, the incision is up to the inner and outer horns. 3. The wound edge is peeled up and down to expose the orbicularis muscle. 4. Remove a narrow strip of orbicularis muscle fibers. 5. Separate the muscles from the fascia and use a knives to thin the slab thicker to the normal slab thickness. The Snellen method cuts the tarsal plate into a narrow strip of triangles that point to the conjunctival surface. 6. Stitch the first needle suture in the center of the skin incision, first through the skin to invade the lower lip, then through the upper lip of the incision, and then out of the skin from the upper lip of the skin. The second to fifth stitches on both sides are stitched in the same manner. 7. When ligating, the central suture is first ligated, and then the remaining sutures are ligated separately to achieve the purpose of correcting the varus. 8. Finally, between the 5 sutures, each stitch is 1 stitch to help the skin wound. 9. After the operation, the eye pad and gauze dressing bandage are bandaged. Change the dressing every day and remove the suture after 7 days. This surgery can achieve the dual purpose of resolving the shape of the fascia and restoring the position of the gingival margin.