Relationship between lower eyelid epiblepharon and epicanthus in Korean children

PURPOSE This study aimed to determine the relationship between lower eyelid epiblepharon and epicanthus in Korean children. METHODS We performed a retrospective review of the medical records and preoperative photographs of 119 patients. These patients were aged 18 years or younger who underwent lower lid epiblepharon repair from January 2010 to December 2012. We also included 119 age- and sex-matched controls. RESULTS The mean age of the patients was 5.7 years (range: 2-16 years) in both groups. The presence of an epicanthal fold was common in each group (98.3%). The inner intercanthal distance/interpupillary distance (IICD/IPD) ratio was significantly greater in the epiblepharon group than in the control group (mean: 0.70 vs 0.67, p<0.001), especially in those aged 5 years or older. The IICD/outer intercanthal distance ratio was also greater in the epiblepharon group than in the control group (mean: 0.48 vs 0.46, p<0.001). The IICD/IPD ratio decreased with growth in the control group, but it did not decrease with growth in the epiblepharon group. The configuration of the epicanthus, in which the upper skin fold formed a confluent fold with the lower eyelid, had a higher prevalence in the epiblepharon group than in the control group (p = 0.001), especially in those aged 5 years or older. CONCLUSION In early childhood (<5 years), the relationship between epicanthus and epiblepharon cannot be established because of the high prevalence of epicanthus in children with or without epiblepharon. In children aged ≥5 years, persistent epicanthus was related to severe epiblepharon formation requiring corrective surgery.