過度の内眼角形成術後修正のための古川法の工夫と応用

The Furukawa Correction Method for Complications after a Canthoplasty for Mongolian Folds

はじめに

　内眼角形成術（以下，目頭切開）は，東洋人に多く，日本人の約70 ％に見られる内眼角贅皮（蒙古襞：mongolian fold） 1）に対するコンプレックス解消や，二重を平行型にして目をより大きく見せるために要望の多い手術である。一方，術後に内眥間距離が狭くなりすぎ，つまり目頭の開きすぎが気になる，似合わない，イメージが違う，と違和感を覚える患者なども少なくない 2）。しかし，内田法 1）や平賀法 3）で皮膚を切除している場合はもちろん，Z形成 4）でも多少の余剰皮膚をトリミングすることもあり，元の目頭に戻すことは極めて困難である 2）。

　古川が二十年以上前に初めて報告した目頭切開術後の修正手術（古川法） 5）6）を改良して，過度の目頭切開術後の修正手術を手がけてきた。さらに，古川法における目頭切開術後の瘢痕を隠すために工夫・応用している。その術式と代表症例を報告する。

　A canthoplasty for a Mongolian fold is a surgery designed to address the psychological issue that some patients have regarding their heavy Mongolian folds, or when patients desire a procedure to make their double eyelid folds more evenly parallel. Because of the frequency of canthoplasties, the ratio of dissatisfied outcomes of this surgery is not insignificant. When the Uchida method or Hiraga method is used to totally eliminate the skin or when the Z-plasty method is used to trim partial skin, reconstruction to the original shape with the limited remaining skin is very difficult.

　Taking the Furukawa correction method (2000, Japan) as the base, we have made adjustments and improvements to the V-Y method and have performed several corrective surgeries that delivered positive results. We have been performing corrective surgeries on patients who underwent a canthoplasty for Mongolian folds at other institutions that resulted in overcorrection complications and have conducted corrective surgeries using the Furukawa method, with many positive results.