Purpose

To identify early postoperative risk factors predicting 3-month recurrence in lower eyelid epiblepharon surgery, focusing on 2-week clinical findings.

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Methods

This retrospective multicentre study involved 234 eyes (117 patients) at two sites. All procedures used standardized techniques by different experienced surgeons. Baseline factors (age, sex, BMI, thyroid-associated ophthalmopathy, epicanthal fold) were collected. Postoperative 2-week assessments included ‘recurrence tendency’ and ‘skin surplus’. Multivariate logistic regression (enter method) with eight variables identified independent predictors for 3-month recurrence, excluding ‘2-week recurrence’ to avoid over-adjustment.

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Results

Clinical recurrence at 3 months was 17.5%. This rate, slightly higher than previous reports, is attributed to our stricter, more sensitive definition of recurrence and relatively early evaluation. Multivariate analysis revealed that 2-week recurrence tendency (OR: 4.45; 95% CI: 1.91–10.40; p < 0.001) and 2-week skin surplus (OR: 3.35; 95% CI: 1.53–7.34; p = 0.002) were strong independent predictors. Systemic factors showed no significant correlation.

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Conclusion

Clinical findings at 2 weeks are powerful predictors of 3-month outcomes. A stricter definition allows early identification of high-risk cases before clinical failure. Specifically, persistent skin surplus and recurrence tendency are critical risk factors regardless of the surgeon. As skin surplus is modifiable, early assessment and potential intervention may improve long-term success.

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Additional Authors

First name	Last name	Base Hospital / Institution
TOMOYUKI	KASHIMA	Oculofacial Clinic Group

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